血毒性蛇咬伤患者的人口学和临床特征研究

K. Ramanathan, H. Vasudevan
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摘要

背景:在印度,蛇咬伤是一个重要的医疗紧急情况和住院的原因。在南印度有一个主要的血毒性咬伤。导致致命蛇咬伤的因素包括抗蛇毒血清剂量问题、治疗延误以及未能观察和治疗并发症。目的:探讨血毒性蛇咬伤患者的人口学特征、临床特点、并发症及转归。对象和方法:本研究是在某三级政府医院进行的为期一年的以医院为基础的观察性研究。研究了血毒性蛇咬伤患者的临床和人口统计学特征以及导致预后不良的因素。统计分析:均值、标准差、百分位数和频率,连续和分类数据为百分比,比例之间的相关性为卡方检验,p < 0.05为统计学显著性。结果:对100例血毒蛇咬伤患者进行了研究。以40 ~ 60岁男性患者居多(63%)。患者多为农民和农村出身的劳动者。92%的患者在咬伤后6小时内入院。局部表现以咬肢肿胀、淋巴结压痛为主。有出血表现的占31%。最常见的并发症是急性肾损伤,发生率为10%。死亡率为3%。结论:导致预后不良的因素是咬伤到入院的时间和是否存在急性肾损伤。
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A Study on the Demographic and Clinical Profile of Patients with Haemotoxic Snake Bite
Background: In India, snake bite is an important medical emergency and reason for hospital admission. There is a predominance of haemotoxic bites in South India. Factors contributing to fatal snake bite include problems with dosage of antivenom, delay in treatment and failure to observe and treat complications. Objectives: To study the demographic and clinical profile, complications and outcome in patients with haemotoxic snake bite. Subjects and Methods: This was a hospital based observational study conducted in a tertiary government hospital for a period of one year. The clinical and demographic profile of patients with haemotoxic snake bite and factors contributing to poor outcome were studied. Statistical analysis: Mean, Standard deviation, Percentiles and frequency, Percentages for continuous and categorical data, Chi square test for association between proportions and p < 0.05 for statistical significance. Results: A total of 100 patients of haemotoxic snake bite were studied. The majority were male patients (63%) in the age group of 40-60 years. Most of the patients were farmers and labourers from a rural background. 92% of the patients were admitted within 6 hours of the bite. Local manifestations that were commonly seen were swelling of the bitten limb and tender lymphadenopathy. Bleeding manifestations were seen in 31%. The most common complication was acute kidney injury seen in 10%. Mortality rate was 3%. Conclusion: Factors contributing to poor outcome were duration between bite and admission and presence of acute kidney injury.
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