Comparative Analysis Of The Clinical Characteristics Of Trimeresurus Albolabris And Russell's Viper Bite Envenomation

AIM: To compare and analyze the clinical characteristics of Trimeresurus albolabris and Russell's viper bite envenomation,and to explore their similarities and differences in diagnosis and treatment,so as to provide help for clinical optimization of the treatment of these two kinds of snake bite envenomation.MATERIALS AND METHODS: The complete data of patients with Trimeresurus albolabris bite envenomation(group A: 26 cases)and Russell's viper bite envenomation(group B: 16 cases)in our hospital from January 1,2010 to December 31,2018 were retrospectively analyzed.The bite condition,visiting time,injury grade,clinical manifestations,laboratory indicators,treatment methods,hospitalization time and prognosis of the two groups were compared and analyzed.RESULTS: 1.General data: There was no significant difference in gender composition,age,occupation,bite time,bite season and bite site composition between the two groups(P > 0.05).2.Clinical characteristics: Compared with group A,group B had earlier visiting time,higher proportion of moderate to severe patients,higher incidence of secondary swelling and pain,subcutaneouscongestion and stasis,hematuria,shock,AKI and MODS,as well as longer hospitalization time and worse prognosis(P < 0.05 for each).3.Laboratory indicators: Compared with group A,the peak time of APTT and PT prolongation,FDP and D-D elevation in group B was earlier(P < 0.05 for each);FIB decreased more significantly in group B on day 1 and 2 after biting(P < 0.05 for both);Compared with subgroup VT ? 12 h in group B,FIB level decreased more significantly in subgroup VT < 12 h ? 24 h(P < 0.05);In group B,the levels of ALT,AST,Cr and BUN increased more significantly on day 1 and 2after biting(P < 0.05 for each).4.Subgroup analysis in group B: Compared with the non-cryoprecipitation group,the FIB in the cryoprecipitation group increased more significantly on the 4th or 5th day after biting(P < 0.05).CONCLUSIONS: 1.Russell's viper bite envenomation is more serious and the prognosis is worse.Early dynamic monitoring of the hemorrhage and coagulation related indicators is helpful to early evaluation and intervention treatment of the disease.2.Medical staff should fully recognize the characteristics of DIC caused by Russell's viper bite envenomation,and early active treatment to prevent irreversible development of the disease.3.Early detection of FIB is helpful to distinguish Russell's viper bite envenomation from Trimeresurus albolabris bite envenomation.4.In the absence of monovalent antivenom of Russell's viper,application of cryoprecipitation can improve the low fibrinogen status caused by Russell's viper bite envenomation.