Reid H A, Theakston R D
Bull World Health Organ. 1983;61(6):885-95.
The present article reviews current knowledge on the epidemiology, pathophysiology, and treatment of snake bite, with particular reference to the situation in developing countries. There is little reliable information on the incidence of snake bite in many parts of the world, and epidemiological studies are needed, using enzyme-linked immunosorbent assay to identify and quantify serum levels of venom antigen and antibody. The pathophysiology and clinical features of envenoming by medically important snakes are discussed. Antivenom, if used correctly, can reverse systemic poisoning even if given days after the bite. It is therefore wise to wait for the appearance of signs of systemic poisoning before administering antivenom, rather than using it routinely. WHO has designated the Liverpool School of Tropical Medicine as a Collaborating Centre for the Control of Antivenoms, and this Centre now holds a collection of reference venoms from several important snake species. Characterization of these and of standard antivenoms should significantly improve the management of snake bite throughout the world.
本文综述了关于蛇咬伤的流行病学、病理生理学及治疗方面的现有知识，特别提及了发展中国家的情况。世界上许多地区关于蛇咬伤发生率的可靠信息很少，需要开展流行病学研究，采用酶联免疫吸附测定法来识别和量化毒液抗原及抗体的血清水平。文中讨论了具有医学重要性的蛇类所致中毒的病理生理学及临床特征。抗蛇毒血清若使用得当，即使在咬伤数天后给药也能逆转全身中毒。因此，明智的做法是在出现全身中毒迹象后再给予抗蛇毒血清，而非常规使用。世界卫生组织已指定利物浦热带医学院为抗蛇毒血清控制合作中心，该中心现收藏了几种重要蛇类的参考毒液。对这些毒液及标准抗蛇毒血清进行特性鉴定应能显著改善全球范围内蛇咬伤的治疗。
