A CLINICAL STUDY OF 37 CASES OF VENOMOUS SNAKEBITE INJURIES

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  • マムシ咬傷３７例の検討

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Abstract

A total of 37 cases of venomous snakebite injuries treated at the hospital from 1995 to 2004 were enrolled in this clinical study of examining clinical characteristics, the grade classification of swelling, time until appearance of swelling, organic impairment, administration of equine antivenin serum (antivenin), and its effects. The male-to-female ratio was 22:15. Their snakebites were all localized in the extremities. One patient who was seen at the hospital when 40 hours had elapsed since being bitten was associated with multiple organ failure (MOF), and died on the second hospital day. The mean time until the maximum swelling developed was significantly delayed in grade III_??_V swellings compared with that of the grade I_??_II swellings (p<0.001). The incidence of occurrence of organic impairment was significantly higher in grade IV_??_V swellings than that in grade I_??_III swellings (p=0.002). Of eight patients who were administered the antivenin within 4 hours since being bitten, three patients who had grade IV_??_V swelling did not develop MOF. However, all five patients who were administered the antivenin more than 4 hours since being bitten developed grade IV_??_V swellings as well as organic impairment (p<0.02).<br> It is considered that we must deal with venomous snakebites with a prospect of developing more than grade III swelling, if the swelling persists to enlarge even after a lapse of 3 hours following the bites. And administration of the antivenin, if it can be administered within 4 hours after being bitten, may contribute to a decrease in organic impairment in those whose swellings may progress to the grade IV_??_V.

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