南印度毒蛇咬伤死亡概况:基于尸检的研究

K. Shanmugam, S. GerardPradeepDevnath
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摘要

背景:在印度,由于蛇咬伤的发病率和死亡率造成的负担明显更高。据估计,从2000年到2019年,印度约有120万人死于蛇咬伤(平均每年5.8万人)。然而,由于报告不足,蛇咬伤的真正负担尚不清楚。结果:本研究于2016 - 2020年在法医学深度进行。共尸检75例毒蛇咬伤死亡病例。女性39例(52.3例),男性36例(48.0例)。4月至9月报告病例最多,52例(69.4%)。蛇咬伤发生时间以夜间40例(53.3%)次之,日间33例(44.0%);最常见的咬伤发生地点为受害人家中及其周围46处(61.3%),其次是工作场所29处(38.7%)。最常见的部位为下肢咬痕33例(44%)。45 ~ 59岁年龄组22例(23.9%),35 ~ 44岁年龄组19例(25.3%)。大多数病例(65例(86.7%))的蛇种类未知。约40例(53.3%)肾标本表现为急性肾小管伴充血。结论:蚊虫咬伤致死人数高于已有统计数字。本研究的大部分结果与同类研究一致。在这项研究中,蛇的种类在很大程度上是未知的,因为像驼峰鼻蝮蛇这样的新蛇种可以造成致命的咬伤,而且很难识别。关于蛇咬伤的具体区域数据将反映该国蛇咬伤的确切数量,并将在很大程度上有助于起草降低死亡率的政策
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Profile of Snake Bite Deaths in South India: An Autopsy based Stud
Background: The burden due to the morbidity and mortality of snake bite in India is significantly higher. Itis estimated around 1.2 million snakebite deaths (average 58,000/year) has occurred in India from the year2000 to 2019. However the real burden of snake bite is unknown due to under reporting. This study aims tobring out region specific data on fatal snake bitesResults: The study was conducted at the dep of forensic medicine from 2016 to 2020. A total of 75 cases offatal snake bite cases were autopsied. The number of female cases 39 (52.3) and males were 36 (48.0). Themaximum no 52 (69.4%) cases were reported between the months of April to September. The common timefor snake bite was in the night 40 (53.3%) followed by the daytime 33 (44.0%). The place of incidence wheremost of the bites happened was in and around the homes of the victims 46 (61.3) followed by the workplaces29 (38.7%). The commonest site were the bite mark was noted in the lower limbs 33 (44%) cases. Around 22(23.9%) cases were seen in age groups of 45 to 59 years and 19 (25.3%) cases in 35 to 44 years. The speciesof snake in majority of the cases i.e., 65 (86.7%) was unknown. Around 40 (53.3%) cases of kidney samplesshowed acute tubular followed by congestion.Conclusion: The number of fatal bites were comparatively higher than that of the statistics available. Most ofthe findings of our study was consistent with the similar studies. The species of snake was largely unknownin this study because new snake species like hump nose pit viper can inflict fatal bites and are difficult toidentify. Region specific data on snake bite will reflect the exact volume of snake bites in the country andwould largely help in drafting policies to reduce mortality
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