Bauab F A, Junqueira G R, Corradini M C, Silveira P V, Nishioka S de A
Faculdade de Medicina de Catanduva, Brazil.
Trop Med Parasitol. 1994 Sep;45(3):243-5.
Data on 32 cases of Bothrops alternatus (the 'urutu' lance-headed viper) bite admitted to a Brazilian teaching hospital from 1985 to 1992 were retrospectively surveyed. The majority of the bites occurred within the household area, i.e. in the house or its environs (56.3%), in the 15-49 years age group (74.2%), and in the lower limbs (84.3%). The male to female ratio was 1 to 1. 59.4% of the patients were given the antivenom within two hours of the bite. Bites in the household area were commonest in old ladies, whereas all the cases associated with leisure activities, and the majority of the bites associated with labour in the field occurred in men. All patients had local pain and oedema; prolonged clothing time was present in 96.9% of the cases, haemorrhage in 40.6%, blisters in 21.9% and necrosis in 9.4%. A tourniquet was used by 43.8% of the patients. A median of 4 ampoules of antivenom were administered. There was no death in this series. There was no significant trend between increasing age and necrosis, nor between time interval between bite and antivenom administration and occurrence of blisters or necrosis. Presence of blister(s) was associated with necrosis (p = 0.007), but use of a tourniquet, altered clotting time or presence of haemorrhage were not. These findings, compared with those of case series of bites of other species of Bothrops, and contrary to the popular belief, indicate that B. alternatus bite is not always severe, and has even a lower rate of complications.(ABSTRACT TRUNCATED AT 250 WORDS)
对1985年至1992年期间入住巴西一家教学医院的32例被乌鲁图矛头蝮（Bothrops alternatus）咬伤的病例数据进行了回顾性调查。大多数咬伤发生在家庭区域，即在房屋内或其周边（56.3%），年龄在15至49岁之间（74.2%），且发生在下肢（84.3%）。男女比例为1比1。59.4%的患者在咬伤后两小时内接受了抗蛇毒血清治疗。家庭区域的咬伤在老年女性中最为常见，而所有与休闲活动相关的病例，以及大多数与田间劳作相关的咬伤都发生在男性身上。所有患者均有局部疼痛和水肿；96.9%的病例出现了伤口愈合时间延长，40.6%出现出血，21.9%出现水泡，9.4%出现坏死。43.8%的患者使用了止血带。抗蛇毒血清的使用剂量中位数为4支。该系列病例中无死亡病例。年龄增长与坏死之间、咬伤与抗蛇毒血清给药之间的时间间隔与水泡或坏死的发生之间均无显著趋势。水泡的出现与坏死相关（p = 0.007），但止血带的使用、凝血时间改变或出血的出现则与之无关。与其他矛头蝮属物种咬伤的病例系列结果相比，且与普遍看法相反，这些发现表明乌鲁图矛头蝮咬伤并不总是严重的，甚至并发症发生率更低。（摘要截选至250字）
