Moran N F, Newman W J, Theakston R D, Warrell D A, Wilkinson D
Hlabisa Hospital, South Africa.
Trans R Soc Trop Med Hyg. 1998 Jan-Feb;92(1):69-70. doi: 10.1016/s0035-9203(98)90959-2.
During a prospective study of 147 patients with snakebite presenting to a rural South African hospital, 13 of 17 patients (76%) treated with South African Institute for Medical Research (SAIMR) polyvalent antivenom experienced potentially severe early (anaphylactoid) reactions. The most common reaction was generalized urticaria (12; 71%), but 3 cases of angio-oedema (18%), 2 of bronchospasm (12%), and 2 of hypotension (12%) were also observed. Reactions were controlled with adrenaline, antihistamines, and resuscitation. All patients fully recovered from envenoming although the full dose of antivenom was not given to most. Indications for the use of this antivenom should be reconsidered and patients should be given antivenom in a high care setting if possible. Use of antivenom by lay people outside hospital should be discouraged and antivenom manufacturing processes could usefully be reviewed.
在一项针对前往南非一家乡村医院就诊的147例蛇咬伤患者的前瞻性研究中，17例接受南非医学研究协会（SAIMR）多价抗蛇毒血清治疗的患者中有13例（76%）出现了可能严重的早期（类过敏）反应。最常见的反应是全身性荨麻疹（12例；71%），但也观察到3例血管性水肿（18%）、2例支气管痉挛（12%）和2例低血压（12%）。通过肾上腺素、抗组胺药和复苏措施控制了反应。尽管大多数患者未给予全剂量的抗蛇毒血清，但所有患者的中毒症状均完全恢复。应重新考虑使用这种抗蛇毒血清的指征，并且如果可能的话，应在高护理环境中为患者注射抗蛇毒血清。应劝阻非专业人员在医院外使用抗蛇毒血清，并且抗蛇毒血清的生产工艺值得进行审查。
