研究蛇咬伤病例的临床特征、血液学变化和预后

Shubham P. Theng, Rajesh J. Khyalappa
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摘要

背景:蛇咬伤是热带和亚热带国家农村人口面临的常见急症。在印度,大部分蛇咬伤发生在人们赤脚在田间劳作或夜间行走时。全世界已知的蛇有 2000 多种,其中约 400 种有毒。这些蛇属于蝮蛇科、蝰蛇科、蝮蛇属和颊蛇科:方法:在辛杜格的 SDH Sawantwadi 医院内科进行了一项前瞻性研究。研究持续时间为 3 个月(2023 年 5 月至 2023 年 7 月)。研究对象包括所有在 SDH Sawantwadi 住院并有蛇咬伤病史的病例。样本量为 50 个:大多数病例的年龄在 18-30 岁之间,有 19 例(38%),其次是 31-45 岁年龄组 9 例,46-60 岁年龄组 12 例,61 岁及以上年龄组 10 例。有被蛇咬伤病史的患者中,男性占 27 例(54%)。与女性相比,男性被蛇咬伤的比例更高,有 23 例(46%)。14%的蛇咬伤患者活化部分凝血活酶时间(APTT)大于30秒,10%的蛇咬伤患者凝血酶原时间(PT)大于15秒,30%的蛇咬伤患者血小板计数大于11000,22%的蛇咬伤患者血小板计数大于11000,12%的蛇咬伤患者全血凝固试验(WBCT)大于20分钟。90%的患者在治疗后出院,10%的患者在治疗期间死亡。PT与临床结果的相关性显著,P<0.5:结论:PT与蛇咬伤患者死亡率之间的关系具有统计学意义。
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Study clinical features, haematological changes and outcome in snake bite cases
Background: Snake bite is a common acute medical emergency faced by rural populations in tropical and subtropical countries. In India, a large proportion of snake bites occur when people are working barefoot in the fields or while walking at night. More than 2,000 species of snakes are known worldwide, of which around 400 are poisonous. These snakes belong to the families Elapidae, Viperidae, Hydrophiidae and Colubridae. Methods: A prospective was done at medicine department of SDH Sawantwadi, Sindhudurgh. Study duration was 3 months (May 2023 to July 2023). Study population included all cases admitted in SDH Sawantwadi with history of snake bite. Sample size was 50. Results: Majority of cases found in the age group of 18-30 years 19 cases (38%) followed by 9 cases in 31-45 age group, 12 in 46-60 age group and 10 cases in 61 and above group. Majority of patients with history of snake bite were males contributing 27 (54%). Snake bites were more common in males as compared to females 23 (46%). 14% snake bite cases have activated partial thromboplastin time (APTT) >30 seconds, 10% of snake bite cases had prothrombin time (PT) >15 sec, 30% had platelet count <100000, increased leucocyte count >11000 was seen in 22% cases and 12% victims showed whole blood clotting test (WBCT) >20 minutes. Clinical outcome was 90% discharged after treatment and 10% death during treatment. Correlation between PT and clinical outcome is significant at p<0.5. Conclusions: Association between PT and mortality among snake bite patients was statistically significant.  
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