Clinical Analysis Of Chinese Cobra (Naja Naja Atra) Snakebite In 62 Cases

Objective:To summarize the distinctively clinical character and approach the reasonable and effective treatment of Chinese cobra(Naja naja atra) snakebiteMethods:To retrospectively analyze the integrated data of 62 patients those all were bitten by Chinese cobra and hospitalized in the first affiliated hospital in Guangxi Medical University from June 2003 to June 2008.Results:1.The mean time of visiting and hospital day was 14(25.5) hours and 11(10)hours respectively.2.The cure rate was 100%and mortality was 0%, the cases of dermatoplasty was 23 and dermatoplasty rate was 37.10%.3.Those 62 cases were allocated to three groups according to visiting-time:0h＜group A≤12h,12 h＜group B≤24 h and group C＞24 h.All have difference of statistical significance in dermatoplasty rate,organ dysfunction rate and leukocyte rising rate.(P＜0.05).The rate of group A was higher than that of the other groups in dermatoplasty rate,organ dysfunction rate and leukocyte rising rate.In this three groups the dermatoplasty rate was 3.33%,53.85%and 78.95% respectively,the organ dysfunction rate was 10%o,61.54%and 57.89% respectively,the leucocyte rising rate was 3.33%,46.15%and 94.74% respectively.4.The dermatoplasty rate has difference of statistical significance between the bandaging group and the non-bandaging group(p＜0.05),the rate of bandaging group was higher than that of the non-bandaging group,but The organ dysfunction rate has no difference of statistical significance between the bandaging group and the non-bandaging group(p＞0.05).5.All 62 cases of patients in three groups were respectively accepted by three methods of 0.1%rivanol,40%Magnesium Sulfate glycerin and Sulfadiazine Silver,and this methods were treated on partial necrosis of skin and soft tissue swelling.Analyzed the mean time of detumescence,we found that the mean time of detumescence in three groups was(8.81±2.11) days,(7.43±1.34) days and(7.72±2.22) days respectively,and the cure rate has no difference of statistical significance in three groups(F=3.121,p＞0.05).Conclusion:1.Chinese cobra snakebite has its distinct feature;the toxin is not easy to get in blood circulation or is consumed too fast.It mainly injures the local skin and soft tissue through the cytotoxin,and seldom leads to death.2.We should protect the liver,prevent the occurrence of MODS and the necrosis of the skin and soft tissue postively,there is good effect if the patiens were injected cobra antivenins within 12 hours.3.The local bandage would aggravate the skin necrosis and heighten the dermatoplasty rate,so we do not agree to the local bandage in Chinese cobra snakebite.4.The three methods of 0.1%rivanol, 40%Magnesium Sulfate glycerin and Sulfadiazine Silver have much effect for the necrosis of the skin and soft tissue in Chinese cobra snakebite,but at present we cannot prove which method is the best among them.