抗菌减毒法救治蝮蛇咬伤致全身性炎症反应综合征与多脏器衰竭

全身性炎症反应综合征 (SIRS)是由感染或创伤等引起的 ,以过量细胞因子或炎症介质释放为特征的一系列全身性反应。我院自 1 980～ 2 0 0 1年共收治蝮蛇咬伤 3 4 5 2例 ,其中并发 SIRS的共有 2 4 6例 ,经及时抗菌减毒加强治疗并发多脏器功能衰竭(MODS) 48例 ,使 MODS发生率、病死率明显下降 ,其疗效满意 ,现报告如下。1　临床资料1 .1　一般资料　 2 4 6例 SIRS患者中 ,男 1 2 6例 ,女 1 2 0例 ,男女之比为 1 .1∶ 1 ;年龄 3～ 76岁 ,其中 1 8～ 5 0岁的青壮年居多。蝮蛇咬伤至就诊时间 :1～ 5 h3例 ,6～ 1 0 h1 2例 ,1 1～ 2 0 h2 0…     

复方天仙子藤黄散外治蝮蛇咬伤的临床观察

目的 观察复方天仙子藤黄散外治蝮蛇咬伤的疗效.方法 选择98例蝮蛇咬伤患者,随机分为复方天仙子藤黄散治疗组49例.季德胜蛇药片对照组49例.两组经治疗后.观察比较消肿止痛、消除瘀斑等方面的疗效及平均时间.结果 复方天仙子藤黄散治疗组在消肿止痛、消除瘀斑的临床治疗上明显优于季德胜蛇药片对照组.结论 复方天仙子藤黄散是外治蝮蛇咬伤的有效药物.     

中西医结合治疗蝮蛇咬伤患者炎性标志物变化规律研究及疗效观察

目的观察中西医结合治疗蝮蛇咬伤患者炎性标志物水平变化及临床意义。方法将300例蝮蛇咬伤患者随机分为治疗组及对照组,每组150例。对照组采用局部封闭、抗蝮蛇毒血清、糖皮质激素等治疗,治疗组在上述西医治疗基础上给予内服木香三黄解毒汤并外用三黄粉外敷。治疗过程中采集两组患者的外周血标本测定炎性标志物水平,并对患者治疗前后的症状、体征进行评分,观察两组的治疗效果。结果两组患者治疗后的炎性标志物水平均明显下降,治疗组下降幅度优于对照组,差异有统计学意义(P0.05);两组治疗后的症状与体征积分均较治疗前明显下降,治疗组下降幅度明显优于对照组,差异有统计学意义(P0.05)。结论中西医结合治疗蝮蛇咬伤可明显降低患者血清炎性标志物水平,有效改善症状体征,提高临床治愈率。     

三七皂苷对蛇伤致全身炎症反应综合征的影响

目的探讨三七皂苷对毒蛇咬伤致全身炎症反应综合征的影响。方法将60例毒蛇咬伤病人按随机双盲的原则分为两组,治疗组(A组)30例采用常规治疗加用三七皂苷,对照组(B组)30例采用常规治疗。观察两组病人在治疗过程中心率、血压、血常规、体温等的变化,并进行比较。结果A组病人心率、血压、血常规、体温等在治疗过程中的变化均优于B组。结论三七皂苷对毒蛇咬伤病人的全身炎症反应综合征有拮抗作用,有利于蛇伤病人器官功能不全的预防与治疗。     

蝮蛇咬伤致MSOF的临床特点及治疗

我院１９９２～１９９７年共收治蝮蛇咬伤３３４８例,发生多系统器官功能衰竭（ＭＳＯＦ）１１例,占０．３２％,经积极治疗无效死亡６例。现就蝮蛇咬伤所致的ＭＳＯＦ的临床特点和有关治疗讨论如下。１临床资料１．１一般资料１１例蝮蛇咬伤致ＭＳＯＦ患者一般临床资料...     

红光治疗对蝮蛇咬伤伤口愈合和肿胀疼痛的疗效观察

目的观察红光治疗对蝮蛇咬伤伤口愈合和伤肢肿胀、疼痛的临床效果。方法将100例蝮蛇咬伤患者随机分为治疗组和对照组。治疗组给予红光照射治疗,对照组采用传统方法治疗,观察比较两组治疗1周后伤口愈合时间和肿胀、疼痛消退时间。结果治疗组平均伤口愈合时间和肿胀、疼痛消退时间与对照组比较均有统计学意义(P0.05)。结论红光治疗对蝮蛇咬伤伤口愈合、肿胀及疼痛的缓解有促进作用,减轻了病人痛苦,提高了护理效率。     

九味消肿拔毒散外治蝮蛇咬伤临床与实验研究

目的观察九味消肿拔毒散外治蝮蛇咬伤的疗效。方法实验研究采用30只大白鼠局部注射蝮蛇毒造模后,外敷九味消肿拔毒散,并观察不同时段的疗效。另外,采用随机平衡对照设计,选择135例蝮蛇咬伤患者,分为九味消肿拔毒散治疗组90例．季德胜蛇药片对照组45例,外敷治疗后,观察比较消肿、止痛、消除瘀斑等方面的疗效。结果九味消肿拔毒散在动物实验与临床治疗上,其消肿、止痛、消除瘀斑的效果明显优于季德胜蛇药片对照组。结论九味消肿拔毒散是外治蝮蛇咬伤的有效药物。     

艾条箍毒拔毒灸治疗蝮蛇伤患肢的疗效观察

目的 探讨艾条箍毒拔毒灸治疗蝮蛇咬伤患肢临床疗效.方法 将100例蝮蛇咬伤患者随机分成治疗组和对照组各50例.两组均按蝮蛇伤救治常规处理,治疗组加用艾条箍毒拨毒灸治疗,并观察两组簸床疗效、局部症状改善情况及治愈时间.结果 愈显率治疗组96.0%,对照组78.0%,两组比较差异有显著性意义(P＜0.05).局部症状,治疗组治疗后与治疗前及对照组治疗后比较,差异均有非常显著性意义(P＜0.01);对照组治疗前后比较,差异无显著性意义(P＞0.05).痊愈时间,治疗组较对照组明显缩短治疗时间,两组比较差异有非常显著性意义(P＜0.01).结论 艾条箍毒拔毒灸能有效治疗蝮蛇伤患肢,改善局部症状,缩短病程.     

危重型蝮蛇咬伤156例救治体会

蝮蛇为混合毒型,咬伤后易引起严重并发症,以呼吸衰竭和肾功能衰竭最为常见,甚至可引起ＭＯＳＦ,死亡率高。我院１９９０年４月至１９９７年１０月共收住蝮蛇咬伤病人６０４例,其中危重型１５６例。我们在继承季德胜治疗毒蛇咬伤经验的基础上,结合西医综合治疗,取得...     

箍毒拔毒灸治疗蝮蛇咬伤疗效观察

目的 观察箍毒拔毒法治疗蝮蛇咬伤的疗效.方法 将140例蝮蛇咬伤患者随机分为治疗组和对照组各70例,两组均给予常规处理,治疗组在常规治疗的基础上加用箍毒拔毒法进行治疗.结果 治疗组总有效率为91.4%,对照组总有效率为87.1%,两组差异有显著性意义;症状改善方面,治疗组治疗前后比较,差异有极显著性意义(P＜0.01);对照组治疗前后比较,差异有显著性意义(P＜0.05);两组治疗后比较,差异有极显著性意义(P＜0.01).结论 箍毒拔毒灸治疗蝮蛇咬伤能有效的改善症状,提高疗效.     

几种蛇毒抑菌作用的比较

本文通过平板扩散实验观察了蛇岛蝮蛇毒、长白山白眉蝮蛇毒、江浙蝮蛇毒及中华眼镜蛇毒对革兰氏阳性菌和革兰氏阴性菌的抑菌作用。结果表明四种蛇毒对试验菌株均有不同程度的抑菌作用;其中白眉蝮蛇毒对金黄色葡萄球菌的最小抑菌浓度为０．６３ｍｇ／ｍｌ,对大肠杆菌为５．０ｍｇ／ｍｌ。抑菌作用与蛇毒中Ｌ—氨基酸氧化酶的活力有相关性。利用ＣＭ—ＳｅｐｈａｄｅｘＣ－２５ＳｅｐｈｄｅｘＧ—７５一对江浙蝮蛇毒的抑菌成份进行初步的柱层析分离,从纯化的各组份看,Ｌ—氨基酸氧化酶活力高的其抑菌活性也高。     

Prey envenomation does not improve digestive performance in Taiwanese pit vipers (Trimeresurus gracilis and T. stejnegeri stejnegeri)

It has been a common belief that snake venom may help in the digestion of its prey, although direct examples and supporting evidence have not been sufficient. To address this, the present study examined whether pre-injecting natural amounts of pit viper venom into experimental mice may accelerate their digestion by the snakes or gain energy benefit as compared to the control without the envenomation. Live adults of two Asian pit viper species Trimeresurus gracilis and T. stejnegeri stejnegeri, which inhabit the cold and warm environment respectively, were the subjects studied herein. A natural dose of 1.2 mg of each of the pit viper venom in phosphate-buffered saline (PBS) was injected into the mouse (about 10% of the snake mass) before it was being fed to the same species of vipers, while the pit vipers in control group were given mouse injected with sterile PBS. The snakes were kept at 14 °C or 24 °C, and parameters of gut passage time, costs of digestion, and/or digestive efficiency were measured. The results did not support the hypotheses that envenomation facilitates prey digestion. The venom in fact caused longer first defecation time and lower assimilation energy at 14 °C. Besides, the time to reach the oxygen consumption peak, and the first defecation time of T. s. stejnegeri were longer than that of T. gracilis.     

中草药白花蛇舌草等对实验性大肠癌作用机制的研究

目的探讨白花蛇舌草等中药在体内对大肠癌的抑制作用和抑瘤机制。方法以大肠癌裸鼠移植瘤为动物模型,观察肿瘤的生长速度,免疫组化法及肠道菌群培养技术观察大肠癌裸鼠移植瘤PCNA表达及阳性细胞密度、肿瘤坏死因子和白介素6的表达以及肠道菌群的培养。结果白花蛇舌草和仙鹤草用药组肿瘤生长率小于对照组,达50.86%,微生态调节剂组低于用药组;在肠道菌群及免疫调节能力上用药组优于对照组,微生态调节剂组优于用药组。结论白花蛇舌草和仙鹤草在体内能显著抑制大肠癌的生长。     

The isolation of a component of the venom of Trimeresurus okinavensis that causes the aggregation of blood platelets

1. A substance has been isolated from the venom of the Okinawan pit viper (Trimeresurus okinavensis) that causes the aggregation of human blood platelets. The reaction resembles that between platelets and thrombin or connective tissue, in that the platelets release ADP. 2. The purified venom fraction is a protein-polysaccharide, and after Pronase digestion had mol.wt. 4x10(6), containing 10% peptide, 85% neutral sugars and 5% hexosamines. It is distinct from the proteolytic, esterolytic and coagulant materials also present in the venom, and has not been shown to possess any enzymic activity. How it reacts with platelets is not yet known.     

北京及周边地区毒蛇咬伤局部组织坏死原因分析

目的对毒蛇咬伤后组织坏死的原因进行分析,用于指导有针对性的预防和治疗．方法回顾近2年我院收治的毒蛇咬伤病衡。选择资料完整的106便组织坏死的留观病人进行分析．结果本组毒蛇咬伤后组织坏死发生率为15％．封闭、消肿、切开排毒和捆扎方法不当可引起或加重组织的缺血和坏死。结论毒蛇咬伤后组织坏死的原因复杂。有针对性地进行治疗可降低组织坏死发生率．     

Primary specificity of ancrod, the coagulating serine proteinase from the Malayan pit viper (Agkistrodon rhodostoma) venom

Values of steady-state and pre-steady-state parameters for the hydrolysis of ZArgONp and ZLysONp catalysed by ancrod, the coagulating serine proteinase from the Malayan pit viper (Agkistrodon rhodostoma) venom, have been determined, between pH 2.5 and 8 (I = 0.1 M) at 21 +/- 0.5 degrees C, and analysed in parallel with those of bovine alpha-thrombin and porcine pancreatic beta-kallikrein-B. In addition to the well-known coagulating behaviour, ancrod also shows catalytic properties, in the hydrolysis of ZArgONp and ZLysONp, reminiscent of those of porcine pancreatic beta-kallikrein-B.     

Selective Labeling of [3H]2-Deoxy-d-Glucose in the Snake Trigeminal System: Basal and Infrared-Stimulated Conditions

[³H]2-Deoxy-d-glucose (2-DG) and high-resolution autoradiography were employed to investigate labeling patterns of the trigeminal and infrared sensory system in acrotaline snake, the pit viper (Trimeresurus flavoviridis). Following intracardiac injection of 9.25 MBq [³H]2-DG, neurons in the nucleus of the lateral descending trigeminal tract (LTTD), nucleus reticularis caloris (RC), nucleus trigemini mesencephalicus, nucleus trigemini motorius, and trigeminal ganglia were labeled in various degrees after the pit organ had been removed (basal condition). This revealed that a higher rate of glucose utilization occurred in these nuclei than in the common sensory trigeminal nuclei, which lacked labeling entirely. When a pit was stimulated periodically with an infrared stimulus for 45 min, the difference in percentage of labeled cells was ipsilaterally increased by 12.84% in large cells of the LITD and by 7.55% in the RC, as compared with the contralateral, basal-condition side. These slight changes indicate a small increase of glucose consumption during infrared reception. On the other hand, the small cells in the LTTD showed labeling that did not change with stimulation, suggesting that 2-DG uptake in inhibitory interneurons is relatively constant.     

Oleic acid-induced lung injury in rabbits: effect of fibrinogen depletion with Arvin

The role of fibrinogen in the evolution of the increased permeability after oleic acid-induced lung injury was studied in New Zealand White rabbits. Animals depleted of fibrinogen by treatment with Malayan pit viper venom were compared with untreated rabbits immediately and at 1 and 24 h after injury. The increased permeability to albumin and elevated extravascular lung water (EVLW) associated with lung injury returned to control values by 24 h in untreated animals. Fibrinogen-depleted animals had a higher mortality (10/25 vs. 2/17, P less than 0.02) and showed a greater immediate increase in permeability to albumin that returned to control values at 1 and 24 h after injury, as well as trends toward elevated blood-free dry lung weight and larger increases in EVLW that persisted for 24 h. These findings indicate that fibrinogen-related proteins play an important role in controlling the microvascular injury that is produced by oleic acid. However, when these proteins are depleted, other mechanisms partially control the leak at later stages of the repair process.