Acil Servise Yılan Isırması Nedeniyle Başvuran Hastaların Demografik ve Klinik Özellikleri

Year 2020, Volume: 2 Issue: 2, 72 - 78, 01.07.2020

Mustafa Sencer Seğmen Selen Acehan Akkan Avci , Müge Gülen , Salim Satar

https://doi.org/10.38175/phnx.623049

Cited By: 2

Abstract

Amaç:
Yılan zehirlenmeleri ciddi mortalite ve morbiditeye neden olabilir. Bu
çalışmada Acil Tıp Kliniğine yılan ısırması tanısı ile başvuran hastaların
hastaneye ulaşma süreleri, ısırılan bölgeleri, klinik evreleri, antivenom
ihtiyacı ve dozları, hastanede kalış süreleri arasındaki ilişki ve kan
biyokimyasındaki değişikliklerinin değerlendirilmesi amaçlandı.

Gereç ve Yöntem:
Çalışmamıza Mart 2011- Haziran 2013 tarihleri arasında Adana Numune Eğitim
Araştırma Hastanesi Acil Tıp kliniğine yılan ısırması şikayeti ile başvuran 34
hasta dahil edildi. Bu çalışmada Acil Tıp Kliniği’ne yılan ısırması tanısı ile
başvuran hastaların hastaneye ulaşma süreleri, ısırılan bölgeleri, klinik
evreleri, antivenom ihtiyacı ve dozları, hastanede kalış süreleri arasındaki
ilişki ve kan biyokimyasındaki değişiklikler değerlendirildi.

Bulgular:
Çalışmamızda Evre 0'da 9 (%26,5) hasta, Evre 1'de 5 (%14,7) hasta, Evre 2'de 17
(%50,0) hasta ve Evre 3'de 3 (%8,8) hasta olduğu saptandı. Klinik takiplerinde
24 saatten daha fazla süre hastanede kalan hastaların antivenom alma oranı ve
antivenom miktarı 24 saatten daha az hastanede kalanlardan anlamlı olarak daha
yüksekti. Çalışmamıza alınan hastalar evrelerine göre Evre 0-1 ve Evre 2-3
olarak iki gruba ayrılarak bu iki grubun aldıkları antivenom dozları
karşılaştırıldı. Evre 2-3 olan gruptaki hastaların aldıkları ortalama antivenom
dozu 4.15±2,06 iken, evre 0-1 grup hastalarda 1,83±1,17 olarak bulundu.

Sonuç: Yılan zehirlenmelerinde evrelemeye göre yüksek doz
antivenom tedavisi önerilse de öncelikli olarak anlık yüksek doz yerine düşük
doz antivenom tedavi ile başlanabilir ve klinik takibe göre ek doz antivenom
tedavi uygulanabilir.

Keywords

Yılan ısırması, antivenom, acil.

Demographic and Clinical Characteristics of Patients Presenting to the Emergency Department with Snakebite

Abstract

Objective: Snake poisonings can cause severe morbidity and
mortality. In this study, it was aimed to evaluate arrival times of the
patients admitted to the Emergency Medicine Department with a diagnosis of
snakebite, bitten areas, clinical manifestations, the need for antivenom doses,
the relationship between the length of hospital stay and changes in blood
biochemistry.

Materials
and Methods: The total
number of 34 patients admitted to the Emergency Department of Adana Numune
Education and Research Hospital between March 2011 and June 2013 were included in
this study. In this study, arrival times of the patients admitted to the Emergency
Medicine Department with a diagnosis of snakebite, bitten areas, clinical
manifestations, the need for antivenom and their doses, the relationship
between the length of hospital stay and changes in blood biochemistry were
evaluated.

Results: In our study, 9 (26.5%) patients were grade 0, 5
(14.7%) patients, were grade 1, 17 (50.0%) patients were grade 2, 3 (8.8% )
patients were grade 3. In the clinical follow-up of the patients, the rate of
antivenom uptake and the amount of antivenom in patients stay in the hospital for
more than 24 hours were significantly higher than the ones that stay in the
hospital less than 24 hours. In our study, patients were divided into two
groups according to the stages with stage 0-1 and stage 2-3, and doses of
antivenoms that they take were compared. The mean dose of antivenom in the
group of patients with stage 2-3 was 4.15 ± 2.06, and this value was 1.83 ±
1.17 in patients with stage 0-1.

Conclusions: Despite high-dose antivenom therapy is recommended
snake poisonings according to the staging, low-dose antivenom therapy should be
considered instead of high-dose antivenom therapy and an additional dose of
antivenom could be used according to the clinical follow-up.

Keywords

antivenom, emergency, snakebite

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