Long-term health complications following snake envenoming
Long-term health complications following snake envenoming
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DOI：
10.2147/jmdh.s126648
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Gnanathasan, Ariaranee
中科院分区：
文献类型：
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作者：
Jayawardana, Subashini;Arambepola, Carukshi;Gnanathasan, Ariaranee
背景：蛇咬伤是世界热带地区一个重要的公共卫生问题。虽然envenoming，如肾功能衰竭，组织坏死，出血素质，神经毒性的破坏性影响是众所周知的，在急性期蛇咬伤后，蛇envenoming的长期影响还没有得到充分study.Materials和方法：一个以人口为基础的研究进行了8707居民在斯里兰卡的农村地区，以评估蛇咬伤后的长期后遗症。健康相关的投诉，蛇咬伤的受害者已经制定了立即或在4周内的咬伤，并持续超过3个月，进行了评估，由访谈者管理的问卷调查和深入访谈，并进一步评估身体检查和相关调查。在816名被确定为蛇咬伤受害者的参与者中，112名（13.7%）至少有一种蛇咬伤相关的长期健康并发症。其中以头痛、眩晕、日光敏感为特征的偏头痛样综合征46例（5.6%）; 26例患者出现肌肉骨骼疾病，如疼痛、局部肿胀、肌无力、畸形、挛缩和截肢。（3.2%）; 21例视力障碍（2.6%）;急性肾损伤4例（0.5%）; 5例患者被咬部位皮肤起水泡（0.6%）;心理困扰2人（0.2%）;偏瘫1例1例（0.1%），右侧面神经麻痹1例（0.1%），咬合部位感觉异常1例（0.1%），全身寒战1例（0.1%），慢性溃疡不愈合1例（0.1%）。有趣的是，31例（3.8%）报告了非特异性躯体症状，如腹绞痛、胸闷、喘息、牙龈退缩、过度脱发和咬伤后身体疼痛的疲倦。自蛇咬伤的症状的平均持续时间为12.7年（SD=11.7）。结论：这项研究强调了一个显着比例的蛇咬伤受害者患有致残慢性健康后遗症。有必要建立系统来解决这些未得到满足的卫生需求。
Background: Snakebite is an important public health problem in tropical regions of the world. Although devastating effects of envenoming such as kidney failure, tissue necrosis, bleeding diathesis, and neurotoxicity are well known in the acute stage following a snakebite, the long-term effects of snake envenoming have not been adequately studied.Materials and methods: A population-based study was conducted among 8707 residents in a rural district in Sri Lanka to assess the long-term sequelae following snakebite. Health-related complaints that snakebite victims had developed immediately or within 4 weeks of the bite and persisted for more than 3 months, were assessed by interviewer-administered questionnaire and in-depth interviews, and further evaluated by physical examination and relevant investigations.Results: Of the 816 participants who were identified as ever snakebite victims, 112 (13.7%) presented with at least one snakebite-related long-term health complication. Among them, "migraine-like-syndrome" characterized by headache vertigo, and photosensitivity to sunlight was found in 46 (5.6%); musculoskeletal disorders such as pain, local swelling, muscle weakness, deformities, contractures, and amputations were found in 26 (3.2%); visual impairment in 21 (2.6%); acute kidney injury in 4 (0.5%); skin blisters at the bite site in 5 (0.6%); psychological distress in 2 (0.2%); hemiplegia in 1 (0.1%); right-side facial nerve palsy in 1 (0.1%); paresthesia over bite site in 1 (0.1%); generalized shivering in 1 (0.1%); and chronic nonhealing ulcer in 1 (0.1%). Interestingly, 31 (3.8%) reported nonspecific somatic symptoms such as abdominal colic, chest tightness, wheezing, receding gums, excessive hair loss, and lassitude with body aches following the bite. The average duration of symptoms since snakebite was 12.7 years (SD=11.7).Conclusion: This study highlights that a significant proportion of snakebite victims suffer disabling chronic health sequelae. There is a need to place systems to address these unmet health needs.