Trevett A J, Lalloo D G, Nwokolo N C, Naraqi S, Kevau I H, Theakston R D, Warrell D A
Department of Clinical Sciences, University of Papua New Guinea, Port Moresby.
Trans R Soc Trop Med Hyg. 1995 May-Jun;89(3):322-5. doi: 10.1016/0035-9203(95)90562-6.
A prospective series of 156 patients systemically envenomed following the bite of a Papuan taipan (Oxyuranus scutellatus canni) were studied. All patients were treated with appropriate antivenom and clinical course and outcome were compared. The proportion of patients requiring intubation was significantly smaller, and the time to resolution of neurotoxicity and discharge from hospital significantly shorter, in patients receiving antivenom no more than 4 h after the bite. No significant difference in outcome was demonstrated between patients receiving antivenom at various times after 4 h. No difference was demonstrated in the times to restoration of coagulability between the 2 groups. The only significant difference between a small number of patients given 2 vials of antivenom and patients given a single vial at the same time after envenoming was a marginally shorter duration of intubation in those who required it. The study suggests that, to achieve significant clinical benefit in Papuan taipan bite, antivenom must be given as early as possible.
对156例被巴布亚太攀蛇(Oxyuranus scutellatus canni)咬伤后出现全身中毒症状的患者进行了前瞻性研究。所有患者均接受了适当的抗蛇毒血清治疗,并对临床病程和结局进行了比较。咬伤后4小时内接受抗蛇毒血清治疗的患者,需要插管的比例显著更低,神经毒性消退时间和出院时间显著更短。咬伤后4小时后不同时间接受抗蛇毒血清治疗的患者,结局无显著差异。两组之间凝血功能恢复时间无差异。少数中毒后同时接受2瓶抗蛇毒血清治疗的患者与接受1瓶抗蛇毒血清治疗的患者之间,唯一显著的差异是需要插管的患者插管时间略短。该研究表明,为了在巴布亚太攀蛇咬伤中获得显著的临床益处,必须尽早给予抗蛇毒血清。