Blaylock R S, Lichtman A R, Potgieter P D
S Afr Med J. 1985 Aug 31;68(5):342-4.
Two cases of proven bites by the Cape cobra (Naja nivea) are reported. Both patients developed areflexic flaccid paralysis and required ventilation from 2 1/4 and 2 1/2 hours after the bite for 4 1/2 and 7 days respectively. Antivenom is of value before the onset of paralysis but of no value once paralysis is established. Both patients developed a non-depolarizing neuromuscular block which was little affected by prostigmine. Early treatment in identified Cape cobra bites should be the immediate application of an arterial tourniquet, followed by intravenous administration of 80-100 ml polyvalent antivenom if signs of neurotoxicity develop. This may need to be repeated. Treatment once paralysis is established is largely supportive, prolonged ventilation frequently being required, following which recovery should be complete.
报告了两例经证实被海角眼镜蛇（Naja nivea）咬伤的病例。两名患者均出现无反射性弛缓性麻痹，分别在咬伤后2又1/4小时和2又1/2小时开始需要通气，通气时间分别为4又1/2天和7天。抗蛇毒血清在麻痹发作前有价值，但一旦麻痹确立则无价值。两名患者均出现非去极化型神经肌肉阻滞，新斯的明对此几乎没有影响。对于已确认的海角眼镜蛇咬伤，早期治疗应立即应用动脉止血带，若出现神经毒性体征，则随后静脉注射80 - 100毫升多价抗蛇毒血清。这可能需要重复进行。一旦确立麻痹，治疗主要是支持性的，常常需要长时间通气，之后应可完全康复。
