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毒蛇咬伤致急性呼吸衰竭的机械通气救治6例 总被引:2,自引:2,他引:0
目的 探讨机械通气救治毒蛇咬伤致急性呼吸衰竭的治疗效果。方法 用机械通气救治6例毒蛇咬伤致急性呼吸衰竭患者。结果 气管内插管是最佳的气道开放方法;控制通气时,理想的参数为潮气量12ml/kg,通气频率20次/分,呼吸比1:2,吸氧浓度0. 4;辅助通气是,压力支持通气为0.3-1.5kPa,触发敏感度为-3mmH2D。气管插管者辅助通气4-6h后撤机及拔管可获得成功。结论 气管内插管及机械通气是救治毒蛇咬伤致急性呼吸衰竭的最有效的方法。 相似文献
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银环蛇咬伤致急性呼吸衰竭的治疗及临床观察 总被引:5,自引:0,他引:5
目的观察抗银环蛇毒血清和机械通气对银环蛇咬伤致急性呼吸衰竭的疗效。方法应用抗蛇毒血清和机械通气救治23例银环蛇咬伤致急性呼吸衰竭患者。结果银环蛇咬伤患者及早应用抗银环蛇毒血清,毒蛇咬伤后发生急性呼吸衰竭时间为2.5~16h。当患者出现睁眼困难、吞咽困难、呼吸节律改变或呼吸困难时,即予气管插管行机械通气,可获得较好的疗效。结论机械通气辅助抗蛇毒血清是救治银环蛇咬伤致呼吸衰竭有效的方法。 相似文献
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80例神经毒类毒蛇咬伤的流行病学特点及急诊救治 总被引:1,自引:1,他引:0
目的总结分析80例神经毒类毒蛇咬伤的流行病学特点及急诊救治经验。方法收集80例神经毒类毒蛇咬伤的临床资料,分析其临床特点并总结救治经验和体会。结果 80例神经毒类毒蛇咬伤抢救成功率100%,痊愈率100%,总有效率100%。结论综合治疗神经毒类毒蛇咬伤的疗效显著。早期使用氧疗和机械辅助呼吸以及抗蛇毒血清等治疗方法是神经毒类毒蛇咬伤呼吸衰竭抢救成功的关键。 相似文献
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毒蛇咬伤致重症肌无力样综合征,主要为神经毒类毒蛇咬伤后引起全身骨骼肌麻痹,包括呼吸肌麻痹,如果抢救不及时,患者多因呼吸衰竭而死亡。我科成功救治1例毒蛇咬伤致重症肌无力样综合征患者,现报告如下。 相似文献
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毒虼咬伤的发病率以夏秋季节最高,常因延误就诊或处理不当而在短时间内出现蛇毒中毒致休克、急性呼吸衰竭、弥散性血管内凝血、急性心力衰竭、急性肾功能衰竭等危重症。因此.及时有效的护理措施是争取抢救时机.改善病情。促进救治成功的关键。我院2006年1月~2008年12月成功救治了s5例毒蛇咬伤的患者,现将急救与护理介绍如下。 相似文献
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血液透析治疗毒蛇咬伤致急性肾功能衰竭的护理 总被引:1,自引:1,他引:0
目的 探讨血液透析治疗毒蛇咬伤致急性肾功能衰竭(ARF)患者的护理.方法 根据对12例毒蛇咬伤致ARF患者的血液透析治疗的护理体会,探讨蛇伤患者血液透析的护理特点.结果 12例患者中11例治疗成功,1例男性患者因合并呼吸衰竭死亡.有效病例血液透析后血肌酐(Cr)、尿素氮(BUN)和尿酸(UA)均明显下降.结论 遵循血液透析的基本原则,注意毒蛇咬伤的特点,有针对性地进行护理,才能保证抢救成功. 相似文献
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儿童毒蛇咬伤的特点与程序化救治的疗效观察 总被引:2,自引:2,他引:0
目的通过分析儿童毒蛇咬伤的特点,评价程序化综合救治方法对儿童毒蛇咬伤的疗效。方法通过观察17例毒蛇咬伤儿童的临床特点,尽早进行病情预测,同时根据毒蛇咬伤的临床病情分型予程序化综合救治。监测病情变化、伤口愈合情况及平均住院时间。结果儿童毒蛇咬伤的特点为不明种类毒蛇咬伤多,症状较成人严重,易发生并发症。经过早期程序化综合救治总有效率100%,伤口渗血、肿胀明显缓解,无1例死亡,平均留观时间4.5天。结论根据儿童毒蛇咬伤特点,早期准确预测和尽快应用程序化救治能提高毒蛇咬伤疗效。 相似文献
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Emilie Alirol Sanjib Kumar Sharma Himmatrao Saluba Bawaskar Ulrich Kuch Fran?ois Chappuis 《PLoS neglected tropical diseases》2010,4(1)
Snake bite is one of the most neglected public health issues in poor rural communities living in the tropics. Because of serious misreporting, the true worldwide burden of snake bite is not known. South Asia is the world''s most heavily affected region, due to its high population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs. Despite increasing knowledge of snake venoms'' composition and mode of action, good understanding of clinical features of envenoming and sufficient production of antivenom by Indian manufacturers, snake bite management remains unsatisfactory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not cover all of the important venomous snakes of the region. Care-givers need better training and supervision, and national guidelines should be fed by evidence-based data generated by well-designed research studies. Poorly informed rural populations often apply inappropriate first-aid measures and vital time is lost before the victim is transported to a treatment centre, where cost of treatment can constitute an additional hurdle. The deficiency of snake bite management in South Asia is multi-causal and requires joint collaborative efforts from researchers, antivenom manufacturers, policy makers, public health authorities and international funders. 相似文献
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Rahman R Faiz MA Selim S Rahman B Basher A Jones A d'Este C Hossain M Islam Z Ahmed H Milton AH 《PLoS neglected tropical diseases》2010,4(10):e860
Background
Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia.Methodology/Principal Findings
We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals'' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4–789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital.Conclusions/Significance
Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted. 相似文献15.
Gomes A Das R Sarkhel S Mishra R Mukherjee S Bhattacharya S Gomes A 《Indian journal of experimental biology》2010,48(9):865-878
Snake bite, a major socio-medical problem of south east asian countries is still depending on the usage of antisera as the one and only source of treatment, which has its own limitations. In India, mostly in rural areas, health centres are inadequate and the snake bite victims mostly depend on traditional healers and herbal antidotes, as an alternative treatment. The present review has been focussed on the varied folk and traditional herbs and their antisnake venom compounds, which might be a stepping stone in establishing the future therapy against snake bite treatment and management. 相似文献
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目的研究血必净注射液联合季德胜蛇药片救治烙铁头蛇咬伤的临床效果。方法将我院收治的69例烙铁头蛇咬伤患者随机分为治疗组34例和对照组35例,两组患者均给予季德胜蛇药片治疗,治疗组同时加用血必净注射液治疗,观察比较两组治疗效果。结果治疗组的痊愈时间、肢体消肿时间均短于对照组,而且凝血功能指标、血小板计数均优于对照组,差异均具有显著统计学意义(均P0.05)。结论血必净注射液联合季德胜蛇药片救治烙铁头蛇咬伤的临床效果显著,有利于减轻患者中毒症状,并能有效缩短痊愈时间,改善凝血功能,增加血小板数量,值得临床推广运用。 相似文献
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Mohammed K. Al-Sadoon 《Saudi Journal of Biological Sciences》2015,22(2):198-203
The present investigation is a retrospective review of snake bites in Riyadh province over the period (2005–2010). A total of 1019 cases of bites admitted to the Ministry of Health medical centers in Riyadh province were analyzed on the basis of age, sex, time of bite and its site on the body, outcome of treatment, antiserum dose and type of snake. Bites occurred throughout the six years with the highest frequency in 2005 and least in 2006 where most of the bite cases were mild and all evolved to cure except four patients who died following the administration of antivenom during 24 h after snake bite. Most of the patients were males (81.7%) and the most attacked age was within the range of 11–30 years (51.5%). All the bites were mainly in the exposed limbs and the most frequently bitten anatomical regions were the lower limbs (427 cases, 41.9%), principally the feet. The study incriminates Cerastes cerastes gasperettii in most of the bites indicating it as the snake of medical importance in Riyadh province. Also, the study indicates low degree of threat in spite of high rate of snake bites as a result of the availability of the medical facilities and the antivenin use in medical centers in Riyadh province. 相似文献
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目的探讨临床上缺乏抗银环蛇蛇毒血清治疗银环蛇咬伤的临床效果。方法将我院急诊科2011年3月~2013年10月收治的银环蛇咬伤患者9例与同期67例应用抗银环蛇毒血清治疗的病例进行比较,观察两组患者住院期间的临床变化与转归。结果经机械通气支持、胆碱酯酶抑制剂联合抗胆碱药物,以及肺部抗感染治疗,9例未经抗银环蛇毒血清治疗的患者均成活,但较使用抗银环蛇毒血清的患者住院时间延长、费用明显增加。结论重症银环蛇伤患者在缺乏抗银环蛇毒血清治疗时,应用机械呼吸支持,胆碱酯酶抑制剂联合抗胆碱药物,以及积极抗感染治疗也能救治患者生命。 相似文献