一家三级医疗中心对蛇咬伤临床概况的研究

Anurekha G, Nallathambi M, Paranthakan C
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摘要

由于印度长期以来一直是外来蛇类出没之地,因此被蛇咬伤是一种严重的职业和农村危害。尽管发病率和死亡率都很高,但医生却很少关注这一职业危害。研究各种临床特征以及从咬伤到开始治疗之间的时间间隔。根据患者病史和明确的咬伤证据对患者进行毒液中毒分类,并根据一系列与治疗开始时间相关的表现对患者进行分级(I-IV),以区分毒蛇和无毒蛇的攻击。除了局部先天性疗法外,患者还必须使用止血带进行局部炎症治疗。在 100 名接受治疗的患者中,很明显,不同蛇类造成的咬伤差异很小。患者到达时发现的异常凝血率较高(78%)。据报告,毒蛇咬伤主要导致原发性凝血异常(84.32%),而神经毒素表现的发生率也较低(11.76%)。这两种症状的出现率也很低(3.92%)。肾功能衰竭的发生率也较高,凝血时间是否正常在很大程度上取决于患者发病后的入院时间。在这项调查中,咬伤与开始治疗之间的时间间隔与凝血异常恢复正常或发生并发症所需的时间无关。这项研究还提出了适当的保护和宣传措施,这些措施可以拯救人类和这些爬行动物。
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A study of clinical profile of snake bite at a tertiary care centre
Because India has long been a land of exotic snakes, snakebite is a serious occupational and rural hazard. Physicians pay very little attention to this occupational hazard despite the high morbidity and death. To study the various clinical profiles and the time interval between bite and start of treatment. Patients were categorized based on the envenomation centred by patient history and definitive bite evidence and graded (I-IV) grounded on a series of manifestations observed in association with the onset of treatment time that distinguishes a venomous from a non-venomous snake attack. Patients were obligating local inflammation owing to tourniquet use besides local innate therapies. Of the 100 patients deliberated, it was evident that there existed a minimal difference between the bites instigated by the snake type. Higher abnormal clotting was perceived on the arrival of patients (78%). While envenomation was predominantly reported to prompt primary coagulation abnormalities (84.32 %), neurotoxin manifestation was also found to occur at a lower rate (11.76 %). Both symptoms were also observed at a minimal level (3.92 %). Higher rates of renal failure were also reported and the clotting time normalization depended largely on patient admission time post-attack. In this investigation, the time gap between the bite and the commencement of therapy was not associated with the time required to normalize the coagulation abnormalities or develop a complication. The study also proposes appropriate protective and awareness measures that could save humankind and these reptiles together.
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