Cruz N S, Alvarez R G
Department of Internal Medicine, Hospital Infantil del Estado de Sonora, Hermosillo, Mexico.
Pediatr Emerg Care. 1994 Feb;10(1):30-3. doi: 10.1097/00006565-199402000-00009.
The Western diamondback rattlesnake, Crotalus atrox, is responsible for the majority of snakebites in Sonora, Mexico. We report 19 cases of children who were attacked by these snakes. Most of the rattlesnake attacks occurred in rural areas during the summer. The children's ages ranged from one to 15 years. The lower extremities, especially the legs, were most often bitten. The signs and symptoms presented by these patients included: pain, edema, limitation of motion, ecchymosis, bleeding and necrosis in the area of the bite, epistaxis, hematuria, and vomiting. Hospital treatment included: parenteral electrolyte solutions, antivenom serum, antibiotics, tetanus toxoid, blood transfusions, hydrocortisone, heparin, and peritoneal dialysis. In one case a fasciotomy was necessary. The observed complications on envenomations included: hemolysis, local necrosis, coagulation disorders, paresthesia, somnolence, and acute renal failure. One death occurred from disseminated intravascular coagulation.
西部菱斑响尾蛇（学名：Crotalus atrox）是墨西哥索诺拉州大多数蛇咬伤事件的罪魁祸首。我们报告了19例被这些蛇袭击的儿童病例。大多数响尾蛇袭击事件发生在夏季的农村地区。儿童年龄从1岁到15岁不等。下肢，尤其是腿部，最常被咬伤。这些患者出现的体征和症状包括：疼痛、水肿、活动受限、瘀斑、咬伤部位出血和坏死、鼻出血、血尿和呕吐。医院治疗包括：胃肠外电解质溶液、抗蛇毒血清、抗生素、破伤风类毒素、输血、氢化可的松、肝素和腹膜透析。有一例需要进行筋膜切开术。观察到的蛇毒中毒并发症包括：溶血、局部坏死、凝血障碍、感觉异常、嗜睡和急性肾衰竭。有一例死于弥散性血管内凝血。
