毒蛇咬伤-咬伤部位和局部反应的意义

A. Venugopalan, Smrithi Vijaykumar, G. Sreekumar, Kripanadhi Karunanithi, B. Prasad, T. Sreekrishnan, G. Kp
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摘要

在印度,蛇咬伤是一种环境和职业危害。蛇咬伤造成的死亡和残疾仍然是一项重大的公共卫生挑战。为了同这场战斗作斗争,应该把更多的投资集中在预防措施上。这包括了解蛇咬伤的常见季节,位置和蛇咬伤的部位。了解这些将有助于采取更好的预防措施。这是一个6年的回顾性观察研究70毒蛇咬伤病例入院的三级保健中心在印度南部。纳入标准已全部确认为毒蛇咬伤中毒病例。卡方检验发现分类变量之间的相关性。研究样本量为70。平均年龄34.66±18.57岁。57.1%为男性。79%的蛇咬伤发生在室外。57.1%的患者出现局部反应并伴有血液毒性/神经毒性症状。28.5%患者仅有局部反应。84%的咬伤发生在下肢。43%的咬伤发生在足部。咬伤部位与局部反应之间存在统计学上的显著相关性(p=0.05)。我们没有发现咬伤部位与局部反应与血液毒性/神经毒性症状之间有统计学意义的相关性(p=0.236)。59%的蛇咬伤发生在季风季节,其次是季风后季节。蛇咬伤是一种被忽视的热带疾病,在现代印度,它仍然是一个被低估的意外死亡原因。咬伤部位的意义以及蛇咬伤的季节变化有助于形成有效的预防策略,并及时进行初级治疗,是减少毒蛇咬伤影响的关键。
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Venomous snakebite — Significance of the bite site and local reaction
Snakebite is an environmental and occupational hazard in India. Death and disabilities due to snakebite remains a major public health challenge. For the fight against this battle a greater investment should be focused on the preventive measures. This includes understanding of the common seasons of snake bites, location and also the site of snake bite. Understanding these will help in taking better preventive measures. This is a 6-year retrospective observational study of 70 venomous snake bite cases admitted to a tertiary care center in South India. Inclusion criteria has been all confirmed case of envenomation by venomous snake bite. Chi square test was done to find the association between categorical variables. The study sample size is 70. Mean age in our study is 34.66 ± 18.57 years. 57.1% were male. 79% snake bites occurred outdoor. 57.1 % patients had local reaction along with hemotoxic/neurotoxic symptoms. 28.5% patients had only local reaction. 84% bites occurred in lower limb. 43% bites occurred in the foot. Statistically borderline significant correlation between site of bite and local reaction alone (p=0.05). We could not find a statistically significant correlation between site of bite and local reaction with hemotoxic / neurotoxic symptoms (p=0.236). 59% snake bites occurred during Monsoon season this was followed by post monsoon season. Snakebite is a neglected tropical disease and remains as an underestimated cause of accidental death in modern India. Significance of bite site along with seasonal variations in snakebites helps in formation of effective preventive strategies, which along with prompt primary treatment holds the key in reducing the impact of venomous snakebite.
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