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2013 年至 2016 年在苏丹娜努扎希拉医院使用的蛇抗毒血清引起的过敏反应发生率。

The prevalence of hypersensitivity reactions to snake antivenoms administered in sultanah nur zahirah hospital from 2013 to 2016.

机构信息

Hospital Sultanah Nur Zahirah, Department of Pharmacy, Kuala Terengganu, Terengganu Darul Iman, Malaysia.

Universiti Teknologi MARA (UiTM), Faculty of Pharmacy, Department of Pharmacy Practice, Puncak Alam, Selangor, Malaysia.

出版信息

Med J Malaysia. 2020 May;75(3):216-220.

Abstract

INTRODUCTION

Snakebite is an important medical emergency. Antivenoms remain the only proven treatment for snake envenoming. However, the use of antivenom is associated with hypersensitivity reactions. The aims of this study were to determine the prevalence and types of hypersensitivity reactions and types and outcomes of pharmacological and non-pharmacological treatments for antivenom reactions among snakebite patients that received antivenoms.

METHODS

This was a 4-year cross-sectional study of snakebite patients from January 2013 to December 2016 in Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data was extracted from the Pharmacy Record on the usage of antivenom and patients of snakebites treated with antivenom were identified. Data of patients were then obtained from the electronic medical records.' Demographic details, clinical features and characteristics of antivenom reactions of patients were recorded in standardized data collection forms and analyzed using chi-square or Mann- Whitney U tests.

RESULTS

Of the 44 patients who received antivenom, 24 (54.5%) developed hypersensitivity reaction. All patients developed reaction early. No patient developed delayed (serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had moderate to severe hypersensitivity reaction and 9 (37.5%) patients had mild reactions. Only one (4.2%) patient presented with bradycardia.

CONCLUSION

The prevalence of early hypersensitivity reaction to snake antivenom in HSNZ was relatively high. Healthcare providers should be aware of the appropriate method of preparing and administering antivenom, and the management for acute hypersensitivity reactions. This will optimize the management of snakebite and ensure patient safety.

摘要

简介

蛇咬伤是一种重要的医疗急症。抗蛇毒血清仍然是蛇咬伤唯一有效的治疗方法。然而,抗蛇毒血清的使用与过敏反应有关。本研究的目的是确定接受抗蛇毒血清治疗的蛇咬伤患者中过敏反应的发生率、类型以及抗蛇毒血清反应的药物和非药物治疗的类型和结果。

方法

这是一项为期 4 年的横断面研究,研究对象为 2013 年 1 月至 2016 年 12 月期间在登嘉楼州苏丹娜努尔·扎希拉医院(HSNZ)接受抗蛇毒血清治疗的蛇咬伤患者。从药房记录中提取抗蛇毒血清使用情况的数据,并确定接受抗蛇毒血清治疗的蛇咬伤患者。然后从电子病历中获取患者的数据。记录患者的人口统计学细节、临床特征和抗蛇毒血清反应特征,并使用卡方检验或曼-惠特尼 U 检验进行分析。

结果

在接受抗蛇毒血清治疗的 44 名患者中,有 24 名(54.5%)发生了过敏反应。所有患者均出现早期反应。无患者发生迟发性(血清病)反应。在 24 名患者中,有 14 名(58.3%)发生中重度过敏反应,9 名(37.5%)患者发生轻度反应。仅有 1 名(4.2%)患者出现心动过缓。

结论

在 HSNZ,蛇抗毒血清早期过敏反应的发生率相对较高。医疗保健提供者应了解准备和使用抗蛇毒血清的适当方法,以及急性过敏反应的管理。这将优化蛇咬伤的管理,确保患者安全。

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