Warrell D A, Davidson N M, Omerod L D, Pope H M, Watkins B J, Greenwood B M, Ried H A
Br Med J. 1974 Nov 23;4(5942):437-40. doi: 10.1136/bmj.4.5942.437.
Echis carinatus is the most important cause of morbidity and mortality from snake bite in Nigeria and in many other parts of the world. Forty-six patients with systemic poisoning by this snake were given echis antivenom made either by the South African Institute for Medical Research (S.A.I.M.R.) or by Behringwerke (North and West African polyvalent antivenom). A simple test of blood coagulability was used to assess whether an adequate neutralizing dose of antivenom had been given. An average of 15.2 ml S.A.I.M.R. antivenom restored normal coagulability permanently in all 23 patients in one group, but in the other group receiving an average dose of 37.9 ml Behringwerke antivenom normal clotting resulted in only 18 out of 23 patients. Local tissue swelling was similar in both groups, but local necrosis occurred in three patients treated with Behringwerke antivenom and in none given S.A.I.M.R. antivenom.
锯鳞蝰是尼日利亚以及世界许多其他地区蛇咬发病率和死亡率的最重要原因。46例被这种蛇咬伤导致全身中毒的患者接受了由南非医学研究所（S.A.I.M.R.）或贝林werke公司（西北非多价抗蛇毒血清）生产的锯鳞蝰抗蛇毒血清治疗。采用一种简单的血液凝固性测试来评估是否给予了足够的中和剂量抗蛇毒血清。一组23例患者平均使用15.2毫升S.A.I.M.R.抗蛇毒血清后，所有患者的凝血功能永久性恢复正常，但另一组平均使用37.9毫升贝林werke抗蛇毒血清的患者中，只有18例（共23例）凝血功能恢复正常。两组局部组织肿胀情况相似，但接受贝林werke抗蛇毒血清治疗的3例患者出现了局部坏死，而接受S.A.I.M.R.抗蛇毒血清治疗的患者无一出现局部坏死。
