İpek Sevcan, Gungor Sukru, Güllü Ufuk U, Dalkıran Tahir, Mercan Mehmet, Demiray Şeyma, Gürbüz Yunus
Pediatric Critical Care, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TUR.
Pediatric Gastroenterology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TUR.
Cureus. 2022 Jan 24;14(1):e21570. doi: 10.7759/cureus.21570. eCollection 2022 Jan.
Snake envenomations are a serious cause of mortality and morbidity in the world.
This study was conducted to investigate snake bites in pediatric patients in Kahramanmaraş and to determine whether pro-brain natriuretic peptide (proBNP) has a prognostic value in these patients.
Pediatric patients aged <18 years who presented to the pediatric emergency department with snakebites were reviewed retrospectively. The demographical, clinical, laboratory, treatments, and outcomes data were collected from their medical records. Stage 0 and 1 envenomation was considered as a non-serious complication and stage 2 and 3 envenomation was considered as a serious complication.
A total of 32 pediatric patients, six females and 26 males, between 2016 and 2021, were included in the study. The mean age was 12.52±3.28 years. There were seven patients without serious complications and 25 patients with serious complications. The best cutoff point for proBNP to predict serious complications was found to be ≥272.5 ng∙L (sensitivity, 83.3%; specificity, 100%, =0.011). We also detected complex regional pain syndrome in one of our patients.
In this study, proBNP was shown to be predictive of a poor outcome of snakebites. Moreover, complex regional pain syndrome, which is rarely reported in the literature, should be kept in mind during the long-term follow-up of snakebites.
蛇咬伤是全球范围内导致死亡和发病的一个重要原因。
本研究旨在调查卡赫拉曼马拉什地区儿科患者的蛇咬伤情况，并确定前脑钠肽（proBNP）在这些患者中是否具有预后价值。
对年龄小于18岁、因蛇咬伤就诊于儿科急诊科的患者进行回顾性分析。从他们的病历中收集人口统计学、临床、实验室、治疗及预后数据。将0期和1期蛇毒中毒视为非严重并发症，2期和3期蛇毒中毒视为严重并发症。
2016年至2021年期间，共有32例儿科患者纳入研究，其中6例女性，26例男性。平均年龄为12.52±3.28岁。7例患者无严重并发症，25例患者有严重并发症。预测严重并发症的proBNP最佳截断点为≥272.5 ng∙L（敏感性83.3%；特异性100%，P=0.011）。我们还在1例患者中检测到复杂性区域疼痛综合征。
在本研究中，proBNP被证明可预测蛇咬伤的不良预后。此外，复杂性区域疼痛综合征在文献中报道较少，在蛇咬伤的长期随访中应予以关注。
