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An Evaluation of Snake Bites and Antivenin Use at a Regional Medical Center

机译：区域医疗中心对蛇咬伤和抗静脉使用药物的评估

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Snake bites are a rare but challenging problem for surgeons. The purpose of our study was to evaluate our experience with snake bites at a regional medical center. We reviewed patients treated for snake bites from 2004 to July 2008. Demographics, clinical information, and outcomes were documented. Descriptive statistics were used, and χ^sup 2^, t test, and Fisher exact test were used to compare patients based on antivenin use. A P value < 0.05 was considered significant. Over the study period, 126 patients presented to the emergency department with 44 (35%) requiring hospital admission. The average age was 38 years (range, 2 to 76 years); 66 per cent were male and 95 per cent white. Bites most commonly occurred in the summer and fall months with none from December through March. Copperhead bites accounted for 50 per cent of bites. An average of 4.8 vials of antivenin was given to 61 per cent of admitted patients with 93 per cent receiving the drug within 6 hours. Minor reactions to antivenin occurred in three patients (11%). Two patients required surgery (5%), and the readmission rate was 7 per cent. There was no known morbidity or mortality. When comparing patients who received antivenin with patients who did not, the only significant clinical variables were an increased prothrombin time (12.1 vs 11.7, respectively; P = 0.048) and a longer length of hospital stay (3 vs 1.8 days, P = 0.0006) in patients receiving antivenin. The majority of patients with snake bites can be treated with supportive care and antivenin when indicated. Antivenin use at our institution is largely based on physical findings and not related to laboratory values. [PUBLICATION ABSTRACT]
机译：蛇咬伤对于外科医生来说是一个罕见但具有挑战性的问题。我们研究的目的是评估我们在区域医疗中心使用蛇咬的经验。我们回顾了2004年至2008年7月接受蛇咬治疗的患者。记录了人口统计学，临床信息和结果。使用描述性统计数据，并使用χ^ sup 2 ^，t检验和Fisher精确检验比较基于抗静脉使用药物的患者。 P值<0.05被认为是显着的。在研究期间，有126名患者到急诊科就诊，其中44名（35％）需要住院。平均年龄为38岁（范围为2到76岁）；男性占66％，白人占95％。咬伤最常发生在夏季和秋季，从12月到3月没有发生。铜头叮咬占叮咬的50％。 61％的入院患者平均使用了4.8小瓶抗静脉素，其中93％的患者在6小时内接受了该药。三名患者（11％）发生了对抗静脉素的轻微反应。两名患者需要手术（5％），再次入院率为7％。没有已知的发病率或死亡率。在比较接受抗静脉酶治疗的患者和未接受抗静脉治疗的患者时，唯一重要的临床变量是凝血酶原时间增加（分别为12.1和11.7； P = 0.048）和更长的住院时间（3天和1.8天，P = 0.0006）。在接受抗静脉蛋白的患者中。如果有指征，大多数蛇咬患者可以接受支持治疗和抗静脉注射治疗。在我们机构中，抗蛇毒蛋白的使用主要是基于物理发现，与实验室值无关。 [出版物摘要]

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    《The American Surgeon》 |2010年第7期|p.755-758|共4页
  • 作者

    Larry I Watson Christy Spivey Cen Rema Menon Cyrus A Kotwall Thomas V Clancy William W Hope;

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    LARRY I. WATSON, M.D., CHRISTY SPIVEY, R.N., M.B.A., CEN REMA MENON, Ph.D., CYRUS A. KOTWALL, M.D., THOMAS V. CLANCY, M.D., WILLIAM W. HOPE, M.D.From South East Area Health Education Center, Department of Surgery, New Hanover Regional MedicalCenter, Wilmington, North CarolinaPresented at the Annual Scientific Meeting and Postgraduate Course Program, Southeastern Surgical Congress, Savannah, GA, February 20-23, 2010.Address correspondence and reprint requests to William W. Hope, M.D., Assistant Professor, Department of Surgery, New Hanover Regional Medical Center, 2131 South 17th Street, P.O. Box 9025 Wilmington, NC 28401. E-mail: william.hope@seahec.net.;

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