Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study.
Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study.
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DOI：
10.4103/0972-5229.106499
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发表时间：
2012-10
期刊：
影响因子：
--
通讯作者：
Kumar R
中科院分区：
文献类型：
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作者：
Saravu K;Somavarapu V;Shastry AB;Kumar R
我们进行了这项研究，以评估不同的蛇envenomation的临床特征和结果的决定因素，以及分配物种特异性的严重程度等级，以不同的情况下，基于临床实验室证据量表。在印度南部的一家三级保健医院，基于临床实验室严重程度分级量表，对76名患者进行了为期2年的前瞻性临床流行病学评价，以确定蛇咬伤毒液蛰入的结局决定因素。主要为男性农业工人（53.9%），其次为家庭主妇（19.7%）和学生（9.2%）。蛇毒中毒综合征的发生率最高（73.68%），其次为眼镜蛇和金环蛇毒中毒综合征（19.73%）和血神经中毒综合征（5.3%）。相反，最大的死亡率和严重程度被认为是金环蛇（60%），其次是眼镜蛇（13.33%）和毒蛇（8.9%）envenomination。在所有蛇种的I级至IV级中毒中，抗蛇毒（ASV）的平均给药剂量从9.83（±7.22）瓶至20.25（±4.92）瓶不等。观察到严重程度等级、ASV剂量和死亡率增加，“咬针时间”相应延迟。此外，最初的传统治疗和金环蛇物种envenomation显着相关的严重程度和死亡率较高的等级。迫切需要在社区中传播意识，以避免传统治疗和在蛇咬伤事件中医疗干预的任何延误。
We undertook this study to assess the clinical profile and outcome determinants of different snake envenomation as well as to assign species-specific severity grade to different cases based on clinico – laboratory evidence scale. A prospective clinico – epidemiologic evaluation for outcome determinants of snakebite envenomation was carried out based on a clinico – laboratory severity grading scale, among 76 patients over a period of 2 years, in a tertiary care hospital in southern India. Majority of patients were male agricultural workers (53.9%) followed by housewives (19.7%), and students (9.2%). Occurrence of viper snake envenomation with hemotoxic syndrome (73.68%) was highest followed by cobra and krait envenomation with neurotoxic (19.73%) and hemo – neurotoxic (5.3%) syndrome, respectively. On the contrary, maximum mortality and severity was seen in krait (60%) followed by cobra (13.33%) and viper (8.9%) envenomation. The average dose of anti-snake venom (ASV) administered varied from 9.83 (±7.22) to 20.25 (±4.92) vials throughout grade I to IV in all snake species envenomation. An increase in severity grade, ASV dose, and mortality were observed with the corresponding delay in ‘bite to needle time.’ Also, initial traditional treatments and krait species envenomation were significantly associated with higher grades of severity and mortality. There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.