Ribeiro L A, Jorge M T, Iversson L B
Departamento de Clínica Médica da Universidade Federal de Uberlândia, MG, Brasil.
Rev Saude Publica. 1995 Oct;29(5):380-8. doi: 10.1590/s0034-89101995000500007.
The attendance given to patients by ta specialized Hospital, in S. Paulo, Brazil, during 1988 is studied. The study is based on the medical records of 322 patients and on questionnaires filled out by author during interviews with 209 patients or their companions. The 322 snake-bites occurred mainly between October and April, in the diurnal period, mainly in the afternoon. Most of patients were adult males, mainly between 10 and 20 years of age. The parts of the body most frequently affected were the feet, hands and legs. The snakes of the genera Bothrops, Crotalus and Micrurus were responsible, respectively, for 306 (95.0%) 14 (4.4%) and 2 (0.6%) of the accidents under study. Among the 160 snakes that were classified at the Herpetological Section of the IB, 152 were Bothrops; 142 B. Jararaca, mostly young reptiles, and 8 were of the genus Crotalus. Of the patients, 90.4% recovered completely, 2.2% presented sequelae, 7.5% were transferred and thus it was impossible to follow them up. Of the 209 persons interviewed, the occupational group most prone to snake bites was agricultural workers, followed by studentes; nearly 60% of the accidents ocurred during work; most of the patients had their inferior extremities unprotected at the moment of the bite. On hundred and sixty patients (76.6%) submitted to some from of treatment before coming to the HVB-IB, the more common being the use of a tourniquet (50.2%), local squeezing in an attempt to remove part of the venom (33.5), application of substances on the site of the snake bite (36.8%) and the ingestion of others (12.9%). Slightly over a quarter of the patients underwent some kind of medical treatment before coming to the HVB-IB, the most common being antissepsis (8.2%), administration of antivenom (6.2%), antihistamines (5.7%) and analgesics (5.3%). The snake was seen before it struch by 187 (89.5%) of the 209 persons interviewed and in most cases it adopted the strike posture just before the first bite.
对巴西圣保罗一家专科医院1988年收治的患者情况进行了研究。该研究基于322名患者的病历以及作者在对209名患者或其同伴进行访谈时填写的问卷。322例蛇咬伤事件主要发生在10月至次年4月的白天时段，主要是下午。大多数患者为成年男性，主要年龄在10至20岁之间。身体最常受影响的部位是脚、手和腿。在本研究的事故中，矛头蝮属、响尾蛇属和珊瑚蛇属的蛇分别导致了306例（95.0%）、14例（4.4%）和2例（0.6%）咬伤。在巴西生物研究所爬虫学部门分类的160条蛇中，152条是矛头蝮；142条是巴西矛头蝮，大多为幼蛇，8条是响尾蛇属。患者中，90.4%完全康复，2.2%有后遗症，7.5%被转院，因此无法对其进行随访。在接受访谈的209人中，最容易被蛇咬的职业群体是农业工人，其次是学生；近60%的事故发生在工作期间；大多数患者被咬时下肢未做防护。160名患者（76.6%）在前往圣保罗大学医学院-巴西生物研究所之前接受了某种形式的治疗，最常见的是使用止血带（50.2%）、局部挤压以试图排出部分毒液（33.5%）、在蛇咬部位涂抹物质（36.8%）以及口服其他东西（12.9%）。略超过四分之一的患者在前往圣保罗大学医学院-巴西生物研究所之前接受了某种医疗治疗，最常见的是消毒（8.2%）、注射抗蛇毒血清（6.2%）、服用抗组胺药（5.7%）和镇痛药（5.3%）。在接受访谈的209人中，187人（89.5%）在蛇咬前看到了蛇，在大多数情况下，蛇在第一次咬之前就采取了攻击姿势。
