Clinical Characteristics Of King Cobra Bite And Analysis Of Therapeutic Effect Of Antivenin

Objective To summarize the clinical features of king cobra (Ophiophagus hannah) snakebite,and explore the effects on mechanical ventilation time which ralates to the different delivery methods of antivenin treatment.Methods Retrospective analysis the clinical data of 22 patiens bitten by the king cobra in the First Affiliated Hospital of Guangxi Medical and other hospitals in Guangxi from April 2004 to May 2009.According to different delivery methods of Antivenin,the patiens were divided into 2 groups.A group: antivenin of Naja naja atra and antivenin of Bungarus multicinctus were used in succession.B group:mixed two antivenin used in a way.By use of statistical methods,compared the two groups of mechanical ventilation time.Results(1) Clinical characteristics:there were 22 cases of respiratory muscle paralysis,the average time from bites to respiratory arrest (128.18±27.83) min,the minimum time of respiratory arrest is 30min,and maximal time is 270min.There were 22 cases of systemic inflammatory response syndrome(SIRS) (2) Therapeutic effect:22 cases were cured,all patients required artificial ventilation.Average time of artificial ventilation in A group is 58.58±11.43 h,the minimal time is 36h,and maximum time is 89h;average time of artificial ventilation in B group is 24.10±3.50h,the minimal time is 17h,and maximal time is 34h.The average time of artificial ventilation in B group is shorter than in A group(P＜0.01).Conclusion The patients of king cobra bite may occur early respiratory paralysis,and to respiratory arrest in severe cases.The majority of patients are required respiratory support,some patients will be damage and dysfunction with heart,liver,kidney.In this set of data,all patients require to respiratory support. There is significant effect in combination with antivenin of Naja naja atra and Bungarus multicinctus.The comparison of two methods,using mixed antivenin and using antivenin in succession,the method of using mixed antivenin can obviously shorten the time of mechanical ventilation.