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首页> 外文期刊>Wilderness & environmental medicine >The Treatment of Unidentified Hematotoxic Snake Envenomation and the Clinical Manifestations of a Protobothrops kelomohy Bite
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The Treatment of Unidentified Hematotoxic Snake Envenomation and the Clinical Manifestations of a Protobothrops kelomohy Bite

机译：治疗未识别的血管毒性蛇形envenomation及Protobothrops Kelomohy Bite的临床表现

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摘要

Hematotoxic snake envenomation is clinically important and has serious complications. This case report describes the clinical manifestations of a bite from a newly described species of hematotoxic snake and the outcomes of treatment using locally available antivenom and supportive management. A 39-y-old male was bitten on his right ankle by an unidentified snake. The patient developed coagulopathy, rhabdomyolysis, and clinical signs of compartment syndrome of his right leg within the first day. Eight doses (30 mL, or 3 vials per dose), or a total of 240 mL, of hemato-polyvalent antivenin (Thai Red Cross, Thailand) were given. Aggressive intravenous hydration and alkalinization of urine were performed, and a fasciotomy was performed for the treatment of suspected compartment syndrome. The patient's clinical symptoms and laboratory results indicated progressive improvement during the 5 d of hospitalization. The snake was later identified as Protobothrops kelomohy, a novel snake species with no clinical data available regarding its envenomation of humans. This case shows that P kelomohy envenomation can produce severe effects that occur both locally and systemically. The benefits of the use of polyvalent antivenom in this situation were unclear. However, with supportive treatment in conjunction with serial clinical and laboratory monitoring, the patient recovered, albeit after 7 d of hospitalization.
机译：血液中毒性蛇毒症在临床上很重要，并且有严重的并发症。本病例报告描述了一种新描述的血液中毒蛇咬伤的临床表现，以及使用当地可用的抗蛇毒血清和支持性治疗的结果。一名39岁男性被一条身份不明的蛇咬伤了右脚踝。患者在第一天内出现凝血障碍、横纹肌溶解症和右腿筋膜室综合征的临床症状。给药8剂（30毫升，或每剂3瓶），或总共240毫升血液多价抗蛇毒血清（泰国红十字会）。对尿液进行积极的静脉补水和碱化，并进行筋膜切开术治疗可疑的筋膜室综合征。患者的临床症状和实验室结果表明，在住院的第5天，病情逐渐好转。后来，这条蛇被确认为克氏原齿蛇（Protobothrops kelomohy），这是一种新的蛇种，没有关于其对人类的毒化的临床数据。该病例表明，海带环境感染可产生局部和全身的严重影响。在这种情况下使用多价抗蛇毒血清的益处尚不清楚。然而，通过支持性治疗以及一系列临床和实验室监测，患者恢复了，尽管住院7天后。

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