蛇咬伤的综合管理:几个主要问题与治疗策略思考

Comprehensive management of snakebite:key issues and consideration of treatment strategies

毒蛇咬伤作为临床常见的急危中毒性疾病,具有发病速度快、症状多样,致残率及死亡率高的特点。自2009年世界卫生组织将蛇咬伤纳入被忽视的热带病名单以来,蛇咬伤的问题引起了全球范围内的广泛关注。近年来,中国发布了《2018年中国蛇伤救治专家共识》和《常见动物致伤诊疗规范(2021年版)》(国家卫健委),这些指导性的专家意见和政府文件对规范蛇咬伤的临床诊疗起着非常重要的作用。尽管如此,中国蛇咬伤的总体死亡率、致残率和总体卫生经济负担依然较高。本文通过广泛收集、整理和分析国内外代表性文献及指南,以问题为导向,对蛇咬伤的救治现状进行系统述评。

As a common acute and critical toxic disease in clinic,snakebite has the characteristics of rapid onset,diverse symptoms,high disability rate and high mortality rate.Since the World Health Organization added snakebites to its list of neglected tropical diseases in 2009,the issue of snakebites has attracted widespread attention worldwide.In recent years,China has issued the 2018 Expert Consensus on the Treatment of Snake Wounds and the National Health Commission's Code for the Diagnosis and Treatment of Common Animal Injuries(2021 edition),which play a very important role in regulating the clinical diagnosis and treatment of snake bites.However,the overall mortality rate,disability rate and overall health economic burden from snakebites in China remain high.Through extensive collection,collation and analysis of domestic and foreign representative literature and guidelines,this paper systematically reviews the current situation of treatment of snakebite.