Watt G, Padre L, Tuazon M L, Theakston R D, Laughlin L W
U.S. Naval Medical Research Unit No. 2, APO San Francisco 96528.
Am J Trop Med Hyg. 1988 May;38(3):618-22. doi: 10.4269/ajtmh.1988.38.618.
The effects of tourniquet application were prospectively studied in 36 hospitalized patients who developed neurotoxic symptoms after bites by the Philippine cobra (Naja naja philippinensis). Tourniquets had been applied in 94% of cases and delayed the onset of symptoms. Four patients were asymptomatic prior to the release of their tourniquet and in 11 patients symptoms worsened precipitously. Most importantly, 4 patients developed complete respiratory paralysis requiring artificial ventilation on its removal. Medical personnel seeing patients after a possible cobra bite should remove any tourniquet very gradually with both specific therapy and ventilatory support at hand. We recommend tourniquet application in the Philippines only after the bite of a definitely identified cobra and when removal can take place under controlled hospital conditions.
对36例因菲律宾眼镜蛇（Naja naja philippinensis）咬伤后出现神经毒性症状的住院患者，前瞻性研究了止血带应用的效果。94%的病例应用了止血带，且延迟了症状发作。4例患者在松开止血带之前无症状，11例患者症状急剧恶化。最重要的是，4例患者在松开止血带后出现完全性呼吸麻痹，需要人工通气。在可能被眼镜蛇咬伤后接诊患者的医务人员，应在有特定治疗和通气支持的情况下，非常缓慢地移除任何止血带。我们建议仅在明确鉴定为眼镜蛇咬伤且能在医院可控条件下移除止血带时，才在菲律宾应用止血带。
