du Toit D M
S Afr Med J. 1980 Mar 29;57(13):507-10.
Very few cases of boomslang (Dispholidus typus) envenomation have been described. A case report is presented, illustrating many pitfalls in diagnosis and treatment. Despite a fully established clinical picture of diffuse intravascular clotting (DIC), response to specific boomsland antivenom was immediate, even as late as 86 hours after the bite. Some of the literature regarding the snake, the clinico-pathological effects of the venom, and treatment is reviewed and discussed. Administration of specific antivenom is the only curative measure, while administration of fresh blood and plasma appears to be the most useful supportive measure. Other measures, including the controversial use of heparin and corticosteroids, are discussed. Reactions to the antivenom, both early and late, are discussed, and methods of prevention and control of reactions are suggested.
已报道的鼓腹咝蝰(Dispholidus typus)咬伤案例极少。本文呈现了一则病例报告,阐述了诊断和治疗过程中存在的诸多陷阱。尽管已完全确立弥散性血管内凝血(DIC)的临床表现,但即便在咬伤后86小时这么晚的时间,使用特效鼓腹咝蝰抗蛇毒血清仍有立竿见影的效果。文中对有关这种蛇、毒液的临床病理效应及治疗的部分文献进行了综述和讨论。使用特效抗蛇毒血清是唯一的治疗措施,而输注新鲜血液和血浆似乎是最有效的支持性措施。还讨论了其他措施,包括肝素和皮质类固醇的争议性使用。文中讨论了抗蛇毒血清的早期和晚期反应,并提出了预防和控制反应的方法。