备受争议的澳大利亚蛇咬伤治疗:最深的伤口

Brian Bush, Paul Singline
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摘要

在澳大利亚,直到20世纪60年代末,毒蛇咬伤的紧急急救治疗包括在咬伤部位切割导致出血,错误地认为这样可以从伤口中冲洗毒素,从而减少病人的全身中毒。然而,它在这方面失败了,反而给病人带来了额外的不适。今天,医院在处理蛇咬伤时,在外科筋膜切开术中再次使用切割。该研究旨在报告2021年10月澳大利亚蛇咬伤后罕见的手部和前臂筋膜切开术,并强调患者由此经历的延长发病率。在西澳大利亚皮尔巴拉地区报道了常见的mulga蛇(Pseudechis australis)咬伤。这一事件是由一名39岁的男性蛇咬伤受害者报告的,他详细叙述了蛇咬伤之前的事件,直到他完成门诊治疗。全世界的共识是,抗蛇毒血清是治疗毒蛇咬伤的主要方法,尽管患者可能会出现类似腔室综合征的症状,但这种疾病极为罕见,特别是在澳大利亚,当地蛇类的毒牙通常太小,无法穿透足够深,导致皮下肿胀。避免手术干预蛇咬伤的治疗导致了更好的结果,为病人。
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Controversial Australian Snakebite Treatment: The Deepest Cut of all
In Australia, until the late 1960s, the emergency first aid treatment for venomous snakebite included cutting to cause bleeding at the bite site in the mistaken belief that it would flush toxins from the wound, thus reducing the patient’s systemic envenoming. However, it failed in this regard and instead caused the patient additional discomfort. Today, again, cutting is used in hospitals during surgical fasciotomies when managing snakebite. The study aimed to report on the rare use of hand and forearm fasciotomies in Australia in October 2021 following snakebite, and highlight the resultant extended morbidity experienced by the patient. Common mulga snake (Pseudechis australis) bite has been reported in the Pilbara region, Western Australia. The incident has been reported by a 39-year-old male snakebite victim, with his narrative detailing the events prior to the snakebite until the completion of his outpatient treatment. The consensus worldwide is that antivenom is the primary treatment for venomous snakebite and, although a patient may present with symptoms mimicking compartment syndrome, this disease is extremely rare, especially in Australia, where the fangs of endemic snakes are generally too small to penetrate sufficiently deep to cause subcutaneous swelling. The avoidance of surgical intervention in snakebite treatment resulted in much better outcomes for the patient.
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