지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2007.1
- 수록면
- 18 - 26 (9page)
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초록· 키워드
오류제보하기
Purpose: Snake venom induced coagulopathy is a major cause of both morbidity and mortality among affected patients. The effects of venomous factors to coagulation cascade and fibrinolysis were verified by analyzing the hematological data and clinical features of envenomed patients, and the efficacy of blood products transfusion and antivenin against a Korean snakebite clarified.
Methods: A retrospective study was conducted on 57 patients, admitted to the Department of Surgery of Chuncheon Sacred Hospital, between July 2002 and October 2005. According to the guidelines for assessing the severity of North American envenomination, the patients were divided into three groups according to severity, and the clinical course, DIC profile and usages of blood products and antivenin then analyzed.
Results: Of the 15 patients in the severe group (26.3%), 9 (60.0%) developed severe coagulation abnormalities, similar to DIC. No substantial bleeding or thrombic event manifested. All the patients with initial hypofibrinogenemia (33.3%) and unmeasured PT/aPTT during the 2nd to 4th hospital days (46.7%) progressed to severe coagulopathy. On average, these patients received transfusions of 18.4±6.1 pints of FFP and 14.4±14.9 pints of platelet product. The average amounts of antivenin applied were 1.2±0.4, 1.7±0.5 and 2.8±0.8 vials for the Minimal, Moderate and Severe groups, respectively. There was no death due to a Korean snakebite during this period.
Conclusion: Korean snake venom is assumed to be a complex mixture of anticoagulant, platelet active and fibrinolytic venom. The discrepancy between abnormal coagulopathy and the clinical course explains venom induced DIC-like syndrome. Hypofibrinogenemia is the most reasonable predictor of DIC-like syndrome. Abrupt prolongation of PT/aPTT during the 2nd to 4th hospital days must weigh against thrombocytopenia. An early antivenin injection, along with the proper use of blood products, could improve the clinical course of envenomed patients.
Methods: A retrospective study was conducted on 57 patients, admitted to the Department of Surgery of Chuncheon Sacred Hospital, between July 2002 and October 2005. According to the guidelines for assessing the severity of North American envenomination, the patients were divided into three groups according to severity, and the clinical course, DIC profile and usages of blood products and antivenin then analyzed.
Results: Of the 15 patients in the severe group (26.3%), 9 (60.0%) developed severe coagulation abnormalities, similar to DIC. No substantial bleeding or thrombic event manifested. All the patients with initial hypofibrinogenemia (33.3%) and unmeasured PT/aPTT during the 2nd to 4th hospital days (46.7%) progressed to severe coagulopathy. On average, these patients received transfusions of 18.4±6.1 pints of FFP and 14.4±14.9 pints of platelet product. The average amounts of antivenin applied were 1.2±0.4, 1.7±0.5 and 2.8±0.8 vials for the Minimal, Moderate and Severe groups, respectively. There was no death due to a Korean snakebite during this period.
Conclusion: Korean snake venom is assumed to be a complex mixture of anticoagulant, platelet active and fibrinolytic venom. The discrepancy between abnormal coagulopathy and the clinical course explains venom induced DIC-like syndrome. Hypofibrinogenemia is the most reasonable predictor of DIC-like syndrome. Abrupt prolongation of PT/aPTT during the 2nd to 4th hospital days must weigh against thrombocytopenia. An early antivenin injection, along with the proper use of blood products, could improve the clinical course of envenomed patients.
목차
서론
방법
결과
고찰
결론
REFERENCES
참고문헌 (19)
참고문헌 신청
1. [학술지(정기간행물)] - Nam SH / 1995 / The evaluation of severe complications in snake bite / J Korean Surg Soc 49 : 856 ~ 866
2. [학술지(정기간행물)] - Gold BS / 2004 / North American snake envenomination: diagnosis, treatment, and management / Emerg Med Clin N Am 22 : 423 ~ 443
3. [학술지(정기간행물)] - Shim JH / 1998 / Ecological study on poisonous snake and investigation of the venom characteristics, snakebiting frequency in Korea / Korean J Env Eco 12 : 58 ~ 77
4. [학술지(정기간행물)] - Kim OY / 1986 / A clinical study of snake bite / J Korean Surg Soc 30 : 386 ~ 392
5. [학술지(정기간행물)] - Lyu HG / 1991 / The management of snakebite: clinical analysis of 160 cases / J Korean Surg Soc 41 : 238 ~ 246
2. [학술지(정기간행물)] - Gold BS / 2004 / North American snake envenomination: diagnosis, treatment, and management / Emerg Med Clin N Am 22 : 423 ~ 443
3. [학술지(정기간행물)] - Shim JH / 1998 / Ecological study on poisonous snake and investigation of the venom characteristics, snakebiting frequency in Korea / Korean J Env Eco 12 : 58 ~ 77
4. [학술지(정기간행물)] - Kim OY / 1986 / A clinical study of snake bite / J Korean Surg Soc 30 : 386 ~ 392
5. [학술지(정기간행물)] - Lyu HG / 1991 / The management of snakebite: clinical analysis of 160 cases / J Korean Surg Soc 41 : 238 ~ 246
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UCI(KEPA) : I410-ECN-0101-2013-514-002674617