Liang Mingxian, Liang Ping, Luo Wei, Wu Yingguang, Peng Mintingn, Yu Peinan
Department of Snake Wound, Wuzhou Hospital of Traditional Chinese Medicine, Guangxi Regional Diagnosis and Treatment Center of Surgery of Traditional Chinese Medicine (Snake Wound Surgery), International Center for Biotoxin Research, Wuzhou 543002, Guangxi Zhuang Autonomous Region, China. Corresponding author: Liang Ping, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 Jan;34(1):85-90. doi: 10.3760/cma.j.cn121430-20210818-01210.
To improve the prevention and treatment of venomous snake bites by analyzing the epidemiological characteristics of venomous snake bite in Wuzhou City, Guangxi Zhuang Autonomous Region.
A retrospective analysis was conducted. The medical records of 1 091 patients with venomous snake bites admitted to the department of snake wound of Wuzhou Hospital of Traditional Chinese Medicine from January 2014 to December 2020 were collected, including snake species, gender and age of patients, bite time, bite site and local symptom.
The medical records of 952 patients with a definite clinical diagnosis of snake bite were enrolled. Among the 952 patients with venomous snake bites, the main bites were from Ovophis (32.98%), Trimeresurus (27.84%) and Naja (26.26%), followed by Bungarus multicinctus (6.51%), Ophiophagus Hannah (3.15%) and Agkistrodonhalys (1.58%), and few bites were from Rhabdophis subminiatus (0.73%), Bungarus fasciatus (0.42%), viper (0.32%) and Agkistrodon (0.21%). Of the 952 patients with venomous snake bites, there were almost twice as many males as females [647 cases (67.96%) vs. 305 cases (32.04%), with male to female ratio of 2.12:1]. The age of patients ranged from 0.8 to 87.0 years old, with 40-59 years old as the majority (42.44%), followed by ≥ 60 years old (27.31%). Snake bites mainly occurred from April to November (93.59%), with a peak in October (16.39%). The incidence time was mainly afternoon (12:00-17:59, 30.88%) and evening (18:00-23:59, 33.30%), followed by morning (06:00-11:59, 24.69%), and early in the morning (00:00-05:59, 11.13%). The incidence time of Ovophis and Bungarus multicinctus mainly concentrated in 18:00-23:59, the time of Trimeresurus was in 06:00-11:59, and that of Naja and Ophiophagus hannah was in 12:00-17:59. Most cases of snake bite were on limbs (98.53%), and mainly on the right limbs (53.57%). The lower limbs mainly were bitten by Ovophis, while the upper limbs mainly were bitten by Naja and by Ophiophagus hannah. The local symptoms of the bite of Ovophis and Trimeresurus were similar, mainly including pain, swelling, tenderness, high temperature of skin around the wound, bleeding and exudation, etc. And the local symptoms of the bite of Naja were pain, swelling, bruising, tenderness, bleeding and exudation, red skin, etc. Numbness and mild pain were the main symptoms of the bite of Bungarus multicinctus and Bungarus fasciatus, but other local characteristics were not obvious.
The majority of venomous snake bite patients in Wuzhou City of Guangxi were middle-aged and elderly males, and the majority of venomous snakes were Ovophis, Trimeresurus, and Naja. Most venomous snake bite occurs from April to November, and the incidence time was concentrated between 12:00 and 23:59. The majority of venomous snake bite was limb bites. The local symptoms were pain, swelling, tenderness, high temperature of skin around the wound, bruising, etc. To reduce the incidence rate, disability rate and mortality of snake bite disease, a snake bite prevention system should be established, the education and publicity of snake bite prevention knowledge should be strengthened, the awareness of snake bite prevention should be improved, and clinical diagnosis and treatment should be assisted, based on the epidemiological characteristics of snake bite in Wuzhou area.
通过分析广西壮族自治区梧州市毒蛇咬伤的流行病学特征，提高毒蛇咬伤的防治水平。
进行回顾性分析。收集2014年1月至2020年12月在梧州市中医医院蛇伤科住院的1091例毒蛇咬伤患者的病历资料，包括蛇种、患者性别和年龄、咬伤时间、咬伤部位及局部症状。
纳入952例临床诊断明确的蛇咬伤患者。在952例毒蛇咬伤患者中，主要咬伤蛇种为竹叶青蛇（32.98%）、烙铁头蛇（27.84%）和眼镜蛇（26.26%），其次为银环蛇（6.51%）、眼镜王蛇（3.15%）和蝮蛇（1.58%），少量咬伤来自红脖颈槽蛇（0.73%）、金环蛇（0.42%）、蝰蛇（0.32%）和五步蛇（0.21%）。952例毒蛇咬伤患者中，男性患者数量几乎是女性患者的两倍[647例（67.96%）对305例（32.04%），男女比例为2.12∶1]。患者年龄范围为0.8至87.0岁，以40～59岁居多（42.44%），其次为≥60岁（27.31%）。毒蛇咬伤主要发生在4月至11月（93.59%），10月达到高峰（16.39%）。发病时间主要集中在下午（12：00～17：59，30.88%）和晚上（18：00～23：59，33.30%），其次是上午（06：00～11：59，24.69%）和凌晨（00：00～05：59，11.13%）。竹叶青蛇和银环蛇的发病时间主要集中在18：00～23：59，烙铁头蛇的发病时间在06：00～11：59，眼镜蛇和眼镜王蛇的发病时间在12：00～17：59。大多数蛇咬伤病例发生在四肢（98.53%），且主要发生在右上肢（53.57%）。下肢主要被竹叶青蛇咬伤，上肢主要被眼镜蛇和眼镜王蛇咬伤。竹叶青蛇和烙铁头蛇咬伤的局部症状相似，主要包括疼痛、肿胀、压痛、伤口周围皮肤温度升高、出血及渗出等。眼镜蛇咬伤的局部症状为疼痛、肿胀、瘀斑、压痛、出血及渗出、皮肤发红等。麻木和轻度疼痛是银环蛇和金环蛇咬伤的主要症状，但其他局部特征不明显。
广西梧州市毒蛇咬伤患者以中老年男性为主，主要毒蛇种类为竹叶青蛇、烙铁头蛇和眼镜蛇。大多数毒蛇咬伤发生在4月至11月，发病时间集中在12：00至23：59。大多数毒蛇咬伤发生在四肢。局部症状为疼痛、肿胀、压痛、伤口周围皮肤温度升高、瘀斑等。应根据梧州地区蛇咬伤的流行病学特征，建立蛇咬伤预防体系，加强蛇咬伤预防知识的教育和宣传，提高蛇咬伤预防意识，并辅助临床诊断和治疗，以降低蛇咬伤疾病的发病率、致残率和死亡率。
