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印度蛇咬伤救治中的临床挑战、争议及区域策略

Clinical challenges, controversies, and regional strategies in snakebite care in India.

作者信息

Abraham Siju V, Mathew Deo, Sreekumar Aravind, George Akhil V, Chanchal Vijay, Kuzhikkathu Kandiyil Purushothaman, Rajeev Punchalil Chathappan, Valuvil Udaya Bhaskaran, Kumar Jayesh, Mohan Kuruvath Bahuleyan, Thomas Joe, Ayyan Manu, Das Sandeep, Sirur Freston Marc, Madhavan Indira, Rafi Aboobacker Mohamed, Mukundan Pradeoth Korambayil, Sunagar Kartik, Krishnan S Vimal, Palatty Babu Urumese

机构信息

Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.

Department of Pediatrics, MES Academy of Medical Sciences, Perinthalmanna, Kerala, India.

出版信息

Lancet Reg Health Southeast Asia. 2025 May 15;37:100598. doi: 10.1016/j.lansea.2025.100598. eCollection 2025 Jun.

Abstract

Snakebite envenomation remains a significant public health issue, particularly in southeast Asia, where diverse venomous snake species and resource-limited healthcare settings complicate effective management. This Health Policy employed thematic analysis of a panel discussion involving multidisciplinary experts with over 300 years of combined experience. Four key themes were identified: (i) the evolution of snakebite treatment paradigms, (ii) clinical and procedural challenges, (iii) debates over controversial practices, and (iv) the role of policy and research in improving outcomes. The findings emphasise the need for region-specific antivenoms, enhanced peripheral healthcare capabilities, and evidence-based treatment protocols. This work provides actionable insights to inform health policy, guide targeted training initiatives, and prioritise research on neglected areas in the management of snakebite.

摘要

蛇咬伤中毒仍然是一个重大的公共卫生问题,特别是在东南亚地区,那里有各种各样的毒蛇物种,且医疗资源有限,这使得有效的管理变得复杂。本卫生政策采用了对一次小组讨论的主题分析,该讨论由具有300多年综合经验的多学科专家参与。确定了四个关键主题:(i)蛇咬伤治疗模式的演变,(ii)临床和程序挑战,(iii)对有争议做法的辩论,以及(iv)政策和研究在改善结果方面的作用。研究结果强调了针对特定区域的抗蛇毒血清、增强周边医疗保健能力以及基于证据的治疗方案的必要性。这项工作提供了可操作的见解,为卫生政策提供信息,指导有针对性的培训举措,并优先开展蛇咬伤管理中被忽视领域的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49c8/12145746/2ee8aa6660dc/gr1.jpg

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