Rudolph R, Neal G E, Williams J S, McMahan A P
Department of Surgical Education, Memorial Medical Center, Savannah, Georgia 31403-3089, USA.
Am Surg. 1995 Sep;61(9):767-72.
Our objective was to determine the prevalence of poisonous snakebite victims admitted to a regional trauma center in Southeastern Georgia over a 10-year period, as well as the type of snake, grade of envenomation, treatment administered, morbidity and mortality, and outcome. Records of patients admitted to the center for snakebite from a 24-county catchment area during the 10-year period (January 1984 to January 1994) were retroactively reviewed. Sixty-three (63) bites in 62 victims of venomous snakebites were treated. The snake distribution was rattlesnake: 19 (30%), copperhead: 18 (29%), cottonmouth moccasin: 8 (12%), unknown: 18 (29%). Envenomation grades were Grade I: 20 (32%), Grade II: 24 (38%), Grade III: 10 (16%), and Grade IV: 9 (14%). Fourteen of 19 (74%) Grades III and IV envenomations were from rattlesnakes. Antivenin was used in all Grade IV and half of the Grade III envenomations. Antivenin was administered within 3 hours of injury in all but one case. Five patients had surgery. Two patients (both Grade I) developed anaphylaxes from antivenin given before hospitalization. All patients recovered. An average of 6 snakebites were treated each year. Expeditious transport, attention to the type of snake inflicting the bite, and judicious use of antivenin will result in a favorable outcome for the snakebite victim.
我们的目标是确定在10年期间入住佐治亚州东南部一家区域创伤中心的毒蛇咬伤患者的患病率，以及蛇的种类、中毒程度、所接受的治疗、发病率和死亡率及转归情况。对该中心在10年期间（1984年1月至1994年1月）收治的来自24个县集水区的蛇咬伤患者记录进行了回顾性分析。共治疗了62例毒蛇咬伤患者的63次咬伤。蛇的分布情况为：响尾蛇19例（30%），铜头蛇18例（29%），水腹蛇8例（12%），不明18例（29%）。中毒程度分级为：Ⅰ级20例（32%），Ⅱ级24例（38%），Ⅲ级10例（16%），Ⅳ级9例（14%）。19例Ⅲ级和Ⅳ级中毒患者中有14例（74%）是被响尾蛇咬伤。所有Ⅳ级和半数Ⅲ级中毒患者使用了抗蛇毒血清。除1例患者外，所有患者均在受伤后3小时内使用了抗蛇毒血清。5例患者接受了手术。2例患者（均为Ⅰ级）在住院前因使用抗蛇毒血清发生过敏反应。所有患者均康复。每年平均治疗6例蛇咬伤患者。迅速转运、关注致伤蛇的种类以及合理使用抗蛇毒血清将使蛇咬伤患者获得良好转归。
