头面部五步蛇咬伤中毒1例  

A case of poisoning caused by head and face bite of Deinagkistrodon acutus

作　　者：刘明俊 刘皖娟 赖林杰 谢璐涛 陈颂如 兰频[1] Liu Mingjun;Liu Wanjuan;Lai Linjie;Xie Lutao;Chen Songru;Lan Pin(Department of Emergency,The Fifth Attiliated Hospital of Wenzhou Medical University,Lishui 323000,China;Department of Emergency,The Second People's Hospital of Jinyun County,Lishui 321400,China)

机构地区：[1]温州医科大学附属第五医院急诊医学科,丽水323000 [2]缙云县第二人民医院急诊科,丽水321400

出　　处：《中华劳动卫生职业病杂志》2023年第8期626-629,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：浙江省医药卫生科技计划项目(2021ZH016);丽水市科技计划项目(2020SJZC049、2022 GYX31);浙江省严重创伤与烧伤诊治重点实验室开放课题(2022K07);缙云县科技计划项目(SF202009)。

摘　　要：蛇咬伤每年致死、致残人数较多。头面部毒蛇咬伤较罕见,容易误诊漏诊,且致死率较高。本文报道头面部毒蛇咬伤中毒1例并文献回顾10例类似病例,归纳头面部毒蛇咬伤中毒的临床特点,为临床诊治提供指导。头面部毒蛇咬伤可能导致气道损伤、水肿,气道梗阻是早期死亡的主要原因,及时进行气管插管或气管切开以保持氧气供应,并尽早使用抗蛇毒血清有助于改善预后。Snake bites kill and maim many people every year.Head and face venomous snake bite is rare,easy to misdiagnose and miss diagnosis,and the fatality rate is high.In this paper,1 case of head and face venomous snake bite poisoning was reported and 10 similar cases were reviewed.The clinical characteristics of head and face venomous snake bite poisoning were summarized to provide guidance for clinical diagnosis and treatment.Head and face venomous snake bites may lead to airway injury,edema,and airway obstruction is the main cause of early death.Timely intubation or tracheotomy to maintain oxygen supply and early use of antivenin can improve prognosis.

关 键 词：蛇咬伤 五步蛇 中毒 头面部蛇咬伤 喉头水肿 血小板减少 

分 类 号：R595.8[医药卫生—内科学]