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哥伦比亚西南部与蝰蛇科蛇咬伤相关的临床综合征。

Clinical syndromes associated with Viperidae family snake envenomation in southwestern Colombia.

作者信息

Cañas Carlos A, Castro-Herrera Fernando, Castaño-Valencia Santiago

机构信息

Department of Internal Medicine, Fundación Valle del Lili, Universidad Icesi, Cali 760032, Colombia.

Department of Physiological Science, Faculty of Health Sciences, Universidad del Valle, Cali 760032, Colombia.

出版信息

Trans R Soc Trop Med Hyg. 2021 Jan 7;115(1):51-56. doi: 10.1093/trstmh/traa081.

Abstract

BACKGROUND

In southwestern Colombia there is a notable variety of snakes that belong to the Viperidae family (vipers). The particular clinical manifestation related to species is poorly reported.

METHODS

Based on a prospective study about envenomation caused by vipers from 2011 to 2019 at the Fundación Valle del Lili Hospital, Cali, in southwest Colombia, we selected cases of admitted patients in which the snakes responsible were fully identified. They were cataloged by clinical syndrome according to prevalent signs (edema-inducing, necrotizing, blister-inducing, procoagulant, anticoagulant or myotoxic) and were related to the species that caused the envenomation.

RESULTS

From a cohort of 53 patients, 21 patients (16 males [72.7%]) with an average age of 35 (3-69) y were included. The syndromes associated with envenomation were anticoagulant and necrotizing effects of Bothrops asper (five patients [22.7%]), blister-inducing and anticoagulant effects of Bothrops rhombeatus (five [22.7%]), anticoagulant effects of Bothrops punctatus (three patients [13.6%]), edema-inducing and anticoagulant effects of Bothriechis schlegelii (five [22.7%]), edema-inducing and myotoxic effects of Bothrocophias colombianus (one [4.5%]), edema-inducing and myotoxic effects of Bothrocophias myersi (one [4.5%]) and edema-inducing effects of Porthidium nasutum (one [4.5%]).

CONCLUSION

In southwestern Colombia there is notable variety in species of snakes belonging to the family Viperidae (vipers) whose envenomation causes various clinical syndromes.

摘要

背景

在哥伦比亚西南部,有多种属于蝰蛇科(蝰蛇)的蛇类。与这些蛇类物种相关的特定临床表现鲜有报道。

方法

基于对2011年至2019年在哥伦比亚西南部卡利市的瓦莱德尔利利基金会医院由蝰蛇咬伤所致中毒的前瞻性研究,我们挑选了那些所涉蛇类已完全明确的入院患者病例。根据主要体征(致水肿、坏死、致水泡、促凝血、抗凝血或肌毒性)将这些病例按临床综合征进行分类,并与导致中毒的蛇类物种相关联。

结果

在53名患者组成的队列中,纳入了21名患者(16名男性[72.7%]),平均年龄为35岁(3至69岁)。与中毒相关的综合征包括:矛头蝮的抗凝血和坏死作用(5名患者[22.7%])、菱形斑纹蝰的致水泡和抗凝血作用(5名[22.7%])、点斑蝰的抗凝血作用(3名患者[13.6%])、施氏竹叶青的致水肿和抗凝血作用(5名[22.7%])、哥伦比亚巨蝮的致水肿和肌毒性作用(1名[4.5%])、迈氏巨蝮的致水肿和肌毒性作用(1名[4.5%])以及纳氏猪鼻蝰的致水肿作用(1名[4.5%])。

结论

在哥伦比亚西南部,属于蝰蛇科(蝰蛇)的蛇类物种繁多,其咬伤会导致各种临床综合征。

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