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探寻动物咬伤后使用抗蛇毒血清治疗的联合当地治疗方法:系统评价。

Prospecting Local Treatments Used in Conjunction with Antivenom Administration Following Envenomation Caused by Animals: A Systematic Review.

机构信息

School of Health Sciences, Amazonas State University, Manaus 69050030, Amazonas, Brazil.

Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus 69040000, Amazonas, Brazil.

出版信息

Toxins (Basel). 2023 Apr 28;15(5):313. doi: 10.3390/toxins15050313.

Abstract

Envenomation caused by venomous animals may trigger significant local complications such as pain, edema, localized hemorrhage, and tissue necrosis, in addition to complications such as dermonecrosis, myonecrosis, and even amputations. This systematic review aims to evaluate scientific evidence on therapies used to target local effects caused by envenomation. The PubMed, MEDLINE, and LILACS databases were used to perform a literature search on the topic. The review was based on studies that cited procedures performed on local injuries following envenomation with the aim of being an adjuvant therapeutic strategy. The literature regarding local treatments used following envenomation reports the use of several alternative methods and/or therapies. The venomous animals found in the search were snakes (82.05%), insects (2.56%), spiders (2.56%), scorpions (2.56%), and others (jellyfish, centipede, sea urchin-10.26%). In regard to the treatments, the use of tourniquets, corticosteroids, antihistamines, and cryotherapy is questionable, as well as the use of plants and oils. Low-intensity lasers stand out as a possible therapeutic tool for these injuries. Local complications can progress to serious conditions and may result in physical disabilities and sequelae. This study compiled information on adjuvant therapeutic measures and underscores the importance of more robust scientific evidence for recommendations that act on local effects together with the antivenom.

摘要

由毒蛇动物引起的毒液中毒可能会引发严重的局部并发症,如疼痛、肿胀、局部出血和组织坏死,此外还会出现皮肤坏死、肌肉坏死,甚至截肢等并发症。本系统评价旨在评估针对毒液中毒引起的局部影响的治疗方法的科学证据。使用 PubMed、MEDLINE 和 LILACS 数据库对该主题进行了文献检索。该综述基于对毒液中毒后局部损伤进行的旨在作为辅助治疗策略的程序的研究。关于毒液中毒后局部治疗的文献报道了多种替代方法和/或疗法的使用。搜索中发现的毒蛇动物包括蛇(82.05%)、昆虫(2.56%)、蜘蛛(2.56%)、蝎子(2.56%)和其他动物(水母、蜈蚣、海胆-10.26%)。关于治疗方法,使用止血带、皮质类固醇、抗组胺药和冷冻疗法是有问题的,植物和油的使用也是有问题的。低强度激光作为这些损伤的一种可能的治疗工具脱颖而出。局部并发症可能会进展为严重情况,并可能导致身体残疾和后遗症。本研究汇集了辅助治疗措施的信息,并强调了在与抗毒液一起作用于局部影响的建议方面,需要更强大的科学证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c68/10223778/90fd50f25a9b/toxins-15-00313-g001.jpg

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