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首页> 外文OA文献 >Revered but Poorly Understood: A Case Report of Dendroaspis polylepis (Black Mamba) Envenomation in Watamu, Malindi Kenya, and a Review of the Literature
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Revered but Poorly Understood: A Case Report of Dendroaspis polylepis (Black Mamba) Envenomation in Watamu, Malindi Kenya, and a Review of the Literature

机译：崇高但理解得很厉害：沃图苏，马林迪肯尼亚的Dendroaspis Polylepis（Black Mamba）envenomation的案例报告，以及对文献的审查

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摘要

The black mamba (Dendroaspis polylepis) ranks consistently as one of the most revered snakes in sub-Saharan Africa. It has potent neurotoxic venom, and envenomation results in rapid onset and severe clinical manifestations. This report describes the clinical course and reversal of effects of black mamba envenomation in a 13-year-old boy in the Jimba area of Malindi. The victim presented to Watamu Hospital, a low resource health facility with labored breathing, frothing at the mouth, severe ptosis and pupils non-responsive to light. His blood pressure was unrecordable, heart rate was 100 beats per minute but thready, his temperature was 35.5 °C, and oxygen saturation was 83%. Management involved suction to clear salivary secretions, several hours of mechanical ventilation via ambu-bagging, oxygen saturation monitoring, and the use of South African Vaccine Producers (SAVP) polyvalent antivenom. Subcutaneous adrenaline was used to stave off anaphylaxis. The victim went into cardiac arrest on two occasions and chest compressions lasting 3–5 min was used to complement artificial ventilation. Hemodynamic instability was corrected using IV infusion of ringers lactate and normal saline (three liters over 24 h). Adequate mechanical ventilation and the use of specific antivenom remain key in the management of black mamba envenomation.
机译：黑曼巴（Dendroaspis Polylepis）一直排名为撒哈拉以南非洲的最受尊敬的蛇之一。它具有有效的神经毒性毒液，并且envenomation导致快速发作和严重的临床表现。本报告介绍了黑曼巴展示在Malindi的Jimba地区13岁男孩中的临床课程和逆转。受害者向沃图乌医院提出，一个低资源健康设施，呼吸困难，口腔发泡，严重的皮层和瞳孔无响应光。他的血压不可核断，心率为每分钟100次，但其温度为35.5°C，氧饱和度为83％。管理层涉及吸入透明唾液分泌物，通过灌木，氧气饱和度监测和使用南非疫苗生产商（SAVP）多价抗血管抗动器的数小时的机械通风。使用皮下肾上腺素止血过敏。受害者在两次中进入心脏骤停，持续3-5分钟的胸部按压用于补充人工通风。使用IV输注ringers乳酸和生理盐水（24小时超过24小时的三升）纠正血流动力学不稳定性。足够的机械通气和特定抗静电子的使用仍然是黑曼展示的管理中的关键。

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