The clinical features and pre-hospital first aid strategies of patients with cobra bites：a retrospec-tive analysis of 115 cases

Bin Wen-kai; He Hua; Liu Bin; Li Wei; Wu Xiao-lin

doi:10.3969/j.issn.1002-1949.2016.11.007

Abstract：Objective To summarize the characteristics of patients with cobra bite, and analyze the different pre-hospital emergency treatments effect on the prognosis of patients with cabra bite. Meth-ods A retrospective study was conducted in Affiliated Nanhua Hospital, Universty of South China from Jan 2014 to Jan 2016. A total of 115 patients bitten by cabra which admitted into Snake Bite and Toxico?sis Unit were included in the study based on inclusion criteria. There were two groups, A group(visit time<8 h)and B group(visit time ≥ 8 h), based on visit time. Data of the patients were collected and analyzed. They were divided into binding group and non-binding group according to pretreatment, and divided into incision group and non-incision group according to pre-treatment. Results ①The mean treatment time was 10.1 h, the earliest l h, the latest 24 h. Fifty-six cases were grafted. Skin graft rate was obviously higher in binding group(72%)than that in non-binding group(30.8%)(P<0.001); se?rum levels of CK and scores of ulcer, swelling were obviously higher in binding group than those in non-binding group(P<0.05). ②Serum levels of biochemical indices(CK, CK-MB), clinical scores(ulcer score, swelling score, illness score), were significantly higher in group A than those in group B(P<0.05). ③There were positive correlation between ulcer score and serum CK or CK-MB, respectively(r=0.778, 0.555); positive correlation between illness score and serum CK and CK-MB were found after cor?relation analysis(r=0.740, 0.693 respectively). Conclusion Cobra bite can cause local tissue necro?sis of patients in a short time, the rate of skin graft is high. Early incision detoxification can significantly improve prognosis of patients with cobra bite and can reduce the extent of tissue necrosis. Improper bind?ing and prolonged treatment are the independent risk factors of skin graft in patients with cobra bite.