Ribeiro L A, Jorge M T
Depto. Clínica Médica, UFU, Uberlândia, MG.
Rev Soc Bras Med Trop. 1997 Nov-Dec;30(6):475-80. doi: 10.1590/s0037-86821997000600006.
Medical records of 3,139 patients bitten by Bothrops snakes and attended at Vital Brazil Hospital (HVB) from 1981 to 1990 were reviewed. They were more frequent in males (75.7%). In 1,412 cases (45.0%) the snake was classified by species, and 1,376 were B. jararaca, 20 B. jararacussu, 11 B. neuwiedi, 2 B. moojeni, 2 B. alternatus e 1 B. pradoi. The most frequent bitten anatomic regions were: foot (47.5%) and hand (21.3%). Tourniquet was used in 38.2% of the cases and its frequency fell down during the study period (p < 0.05). The clinical features at the bite site were: pain (95.6%), swelling (95.4%), ecchymosis (56.1%), blisters (13.8%), necrosis (16.5%), and abscess (11.0%). Systemic manifestations were: bleeding (12.3%), acute renal failure (1.6%), and shock (0.7%). There were blood coagulation disorders in 1,730 (57.9%) of the 2,990 cases. There were 21 amputations (0.7%) and 9 deaths (0.3%). The average serum dose that was used in treatment fell down during the study period (p < 0.001).
回顾了1981年至1990年期间在巴西维塔尔医院（HVB）就诊的3139例被矛头蝮蛇咬伤患者的病历。男性患者更为常见（75.7%）。在1412例（45.0%）病例中，蛇按种类进行了分类，其中1376例为巴西矛头蝮，20例为巴拉那矛头蝮，11例为诺维德矛头蝮，2例为穆耶尼矛头蝮，2例为交替矛头蝮，1例为普拉多矛头蝮。最常被咬伤的解剖部位是：足部（47.5%）和手部（21.3%）。38.2%的病例使用了止血带，其使用频率在研究期间有所下降（p<0.05）。咬伤部位的临床特征包括：疼痛（95.6%）、肿胀（95.4%）、瘀斑（56.1%）、水泡（13.8%）、坏死（16.5%）和脓肿（11.0%）。全身表现包括：出血（12.3%）、急性肾衰竭（1.6%）和休克（0.7%）。在2990例病例中，有1730例（57.9%）出现血液凝固障碍。有21例截肢（0.7%）和9例死亡（0.3%）。研究期间治疗所用的平均血清剂量有所下降（p<0.001）。
