Epidemiology of snakebite in Eshowe, KwaZulu-Natal, South Africa
Epidemiology of snakebite in Eshowe, KwaZulu-Natal, South Africa
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DOI：
10.1016/j.toxicon.2003.11.019
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发表时间：
2004-02-01
期刊：
影响因子：
2.8
通讯作者：
Blaylock, R
中科院分区：
文献类型：
--
作者：
Blaylock, R
对入住埃绍韦医院的333名蛇咬伤患者进行了分析。41人未中毒，282人出现疼痛性进行性肿胀（PPS），7人出现进行性肌无力（PW），还有3例轻度中毒无法分类。肇事的死亡毒蛇包括莫桑比克射毒眼镜蛇（Naja mossambica）、鼓腹咝蝰（Bitis arietans）、比布龙穴蝰（Atractaspis bibronii）、非洲树蛇（Causus rhombeatus）和黑曼巴蛇（Dendroaspis polylepis）。大多数咬伤发生在患者生命的前三十年的潮湿夏季，且多在腿部。大多数患者采取了急救措施。如果患者上肢或脚踝以上部位被咬伤，通常能看到蛇。严重中毒与更快到达医院有关，睡眠中的患者多次被咬的情况更常见。蛇咬伤后未中毒在冬季、成年女性以及肢体近端或手部被咬时更为常见。出现PPS的患者出现了咬伤部位并发症（42例）、骨筋膜室综合征（4例）、股血管受压（1例）、深静脉血栓形成（1例）和呼吸并发症（4例）。严重肿胀与春季和初夏、肢体近端咬伤以及最易发生坏死的儿童有关。手指和手部最易发生坏死和永久性残疾。4名PW患者出现呼吸衰竭。12名患者使用了抗蛇毒血清，其中5人出现急性不良反应。有1人死亡。（C）2003爱思唯尔有限公司。保留所有权利。
Three hundred and thirty-three patients admitted to Eshowe Hospital with snakebite were analysed. Forty-one were non-envenomed, 282 exhibited painful progressive swelling (PPS), seven showed progressive weakness (PW), and there were three cases of minor envenomations that were unclassifiable. Offending dead venomous snakes included Naja mossambica (Mozambique spitting cobra), Bitis arietans (puff adder), Atractaspis bibronii (stiletto snake), Causus rhombeatus (common night adder) and Dendroaspis polylepis (black mamba). Most bites occurred on the leg in the wet summer months during the first three decades of the patients' lives. The majority of patients used a first-aid measure. The snake was most commonly sighted if the patient was bitten on an upper limb or above the ankle. Severe envenomation was associated with quicker arrival at hospital, and multiple bites occurred more frequently in sleeping patients. Non-envenomation following snakebites was more common in winter, in adult females, and if the patient was bitten proximally on a limb or on a hand. Patients with PPS developed bite site complications (42), compartment syndromes (4), femoral vessel entrapment (1), deep vein thrombosis (1), and respiratory complications (4). Severe swelling was associated with spring and early summer, proximal limb bites and children who were most at risk of necrosis. Fingers and hands were most prone to necrosis and permanent disability. Four patients with PW developed respiratory failure. Antivenom was administered to 12 patients, five of whom developed an acute adverse reaction. There was one death. (C) 2003 Elsevier Ltd. All rights reserved.