Rediscovery of severe saw-scaled viper (Echis sochureki) envenoming in the thar desert region of Rajasthan, India
Rediscovery of severe saw-scaled viper (Echis sochureki) envenoming in the thar desert region of Rajasthan, India
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DOI：
10.1580/06-weme-or-078r.1
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发表时间：
2007-06-01
影响因子：
1.4
通讯作者：
Simpson, Ian D.
中科院分区：
文献类型：
--
作者：
Kochar, D. K.;Tanwar, P. D.;Simpson, Ian D.
目标。在印度，毒蛇咬伤仍然是一个谜。虽然被蛇咬伤的人继续使用有几个世纪历史的无效急救治疗，但重要的事实信息。例如被北方锯鳞蝰蛇（Echis sochureki）咬伤的重要性和独特性，已经在很大程度上丢失和遗忘。在本文中，我们报告的第一个系统收集的数据，在拉贾斯坦邦，印度的临床过程中的毒刺E sochureki。临床信息报告12受害者被明确确定E sochureki咬伤，2例临床病例进行了更详细的描述，以说明这种蛇的严重程度。开发了一种数据收集表，用于前瞻性地收集有关被E sochureki咬伤的患者以及将死蛇带到医院的患者的临床信息。所有的蛇都是由一位经验丰富的爬虫学家确定的。收集有关症状和体征、管理（急救和住院）和结局的信息。所有12名受害者都有全身中毒的证据，包括异常的20分钟全血凝固试验（7人全身出血）。所有人都接受了部分制成的多价抗蛇毒血清。来自印度南部的棘蛇毒液抗蛇毒血清在恢复这些患者的凝血方面相对无效。所有患者均存活，但1例患者发生颅内出血伴残余偏瘫。在拉贾斯坦邦，Echis sochureki造成严重咬伤。需要做的工作，以改变急救实践中使用的蛇咬伤在这方面，以鼓励更迅速地介绍到医院，并开发抗蛇毒血清，是更有效地对E sochureki。
Objectives.-In India, venomous snakebite remains an enigma. Although ineffective first aid treatments that are centuries old continue to be used by people bitten by snakes, important factual information. such as the importance and uniqueness of bites by the northern saw-scaled viper (Echis sochureki), has been largely lost and forgotten. In this paper, we report the first systematically gathered data on the clinical course of envenoming by E sochureki in Rajasthan, India. Clinical information is reported on 12 victims bitten by definitively identified E sochureki, and 2 clinical cases are described in greater detail to illustrate the severity of envenoming by this snake.Methods.-A data collection form was developed and used to prospectively gather clinical information regarding patients who were bitten by E sochureki and who brought the dead snake with them to hospital. All snakes were definitively identified by an experienced herpetologist. Information on symptoms and signs, management (both first aid and hospital), and outcomes was collected.Results.-All 12 victims had evidence of systemic envenoming, including abnormal 20-minute whole blood clotting tests (with systemic bleeding in 7). All received polyvalent antivenom made, in part. with Echis carinatus venom from southern India. Antivenom was relatively ineffective in restoring coagulation to these patients. All patients survived, although I patient suffered an intracranial bleed with residual hemiparesis.Conclusions.-Echis sochureki causes severe bites in Rajasthan. Work needs to be done to alter the first aid practices used for snakebites in this area, to encourage more rapid presentation to hospital, and to develop antivenom that is more effective against E sochureki.