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菲律宾眼镜蛇抗蛇毒血清治疗米沙鄢群岛地区神经毒性蛇咬伤中毒:一项2016年至2020年的描述性研究

Neurotoxic snakebite envenomation treated with Philippine cobra antivenom in the eastern Visayas: a descriptive study between 2016 and 2020.

作者信息

Paghubasan Jonathan, Tiglao Patrick Joseph, Aoki Yoshihiro, Tan Mariedel A, Sarsalijo Mardie S, Aquino Grace Joy B, Beronilla-Uraga Mercy Grace, Agosto Lourdes C

机构信息

Department of Emergency Medicine, Eastern Visayas Medical Center, Tacloban, Philippines.

Department of Emergency Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines.

出版信息

Toxicol Res (Camb). 2024 Jun 10;13(3):tfae088. doi: 10.1093/toxres/tfae088. eCollection 2024 Jun.

Abstract

INTRODUCTION

There is a significant shortage of observational studies on neurotoxic snakebite envenomation in the Philippines. This lack of data, especially concerning treatment using Purified Cobra Antivenom (PCAV), has prompted the initiation of this foundational study.

METHODS

The target population included snakebite patients admitted to the Eastern Visayas Medical Center and treated with PCAV between 2016 and 2020. A retrospective chart review was conducted for data collection. The investigation analyzed the hospital stay and patient features of individuals who were administered either lower or higher doses of PCAV.

RESULTS

Eighty-two patients were identified during the study. Of these, 27 (33%) were under 20 years of age and 50 (61%) were male. Most patients, totalling 75 (92%) were hailed from rural areas. Of the 82 patients, 59 (72%) received one or two ampoules of PCAV during the course. However, patients who received more than two ampoules had a longer median hospital stay than those who received less than three ampoules [96 h (interquartile range, IQR 66-122) vs. 125 h (IQR 96-218),  = 0.038]. The study reported five in-hospital mortalities (6.1%).

CONCLUSIONS

The individuals who needed a high dosage of PCAV tended to have more extended hospital stays, yet over 70% of the patient population required a lower dosage. To gain a clearer understanding of the burden of neurotoxic snakebites and determine the optimal PCAV dosage based on disease severity in the area, a more comprehensive, prospective study is recommended.

摘要

引言

菲律宾关于神经毒性蛇咬伤中毒的观察性研究严重不足。数据的缺乏,尤其是关于使用纯化眼镜蛇抗蛇毒血清(PCAV)治疗的数据,促使开展了这项基础研究。

方法

目标人群包括2016年至2020年间入住东维萨亚斯医疗中心并接受PCAV治疗的蛇咬伤患者。通过回顾性病历审查进行数据收集。该调查分析了接受低剂量或高剂量PCAV治疗的个体的住院时间和患者特征。

结果

研究期间共确定了82例患者。其中,27例(33%)年龄在20岁以下,50例(61%)为男性。大多数患者,共计75例(92%)来自农村地区。在82例患者中,59例(72%)在病程中接受了一或两安瓿的PCAV。然而,接受超过两安瓿PCAV的患者的中位住院时间比接受少于三安瓿的患者更长[96小时(四分位间距,IQR 66 - 122)对125小时(IQR 96 - 218),P = 0.038]。该研究报告了5例住院死亡病例(6.1%)。

结论

需要高剂量PCAV的个体往往住院时间更长,但超过70%的患者人群需要较低剂量。为了更清楚地了解神经毒性蛇咬伤的负担,并根据该地区的疾病严重程度确定最佳的PCAV剂量,建议进行更全面的前瞻性研究。

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