You have full access to this article via your institution.

您可以通过您的机构完全访问本文。

Download PDF

下载PDF

Download PDF

下载PDF

Venomous snakes are widely distributed in the world and snakebite envenoming is a medical emergency with high fatality and disability rates1,2. Rapid identification and assessment of the patients affected by venomous snakebite, and accurate and timely medical decision-making are crucial to save the lives of these patients.

毒蛇在世界上广泛分布，毒蛇咬伤是一种医疗紧急情况，死亡率和致残率很高1,2。快速识别和评估受毒蛇咬伤影响的患者，以及准确及时的医疗决策对于挽救这些患者的生命至关重要。

In their article, Gutiérrez and colleagues have comprehensively elaborated the epidemiology, clinical manifestations, assessment and treatment strategies of snakebite envenoming (Gutiérrez, J. M. et al. Snakebite envenoming. Nat. Rev. Dis. Primers 3, 17063 (2017))3. However, after careful literature review, I believe that some supplements need to be made in terms of the indication of antivenom treatment1,2,3.Antivenom is the only specific treatment for snakebite envenoming.

在他们的文章中，Gutiérrez及其同事全面阐述了毒蛇咬伤的流行病学，临床表现，评估和治疗策略（Gutiérrez，J.M.等人，《毒蛇咬伤毒液》，Nat.Rev.Dis。Primers 317063（2017））3。然而，经过仔细的文献回顾，我认为需要在抗蛇毒血清治疗的适应症方面进行一些补充1,2,3。抗蛇毒血清是毒蛇咬伤的唯一特异性治疗方法。

Monovalent serums are often given to victims of venomous snakebites of known species, and polyvalent antivenoms or a combination of multiple monovalent serums are often required for envenomation by unknown venomous snakes1,2. In their article, the authors list the clinical indications in patients that warrant antivenom administration, including systemic and local manifestations3.

单价血清通常被给予已知物种的毒蛇咬伤的受害者，并且未知毒蛇的毒液通常需要多价抗蛇毒血清或多种单价血清的组合1,2。在他们的文章中，作者列出了需要抗蛇毒血清给药的患者的临床适应症，包括全身和局部表现3。

However, it should be noted that the development of an enlarged tender lymph node draining the bitten limb is also a clinical indication for antivenom administration, as per the 2016 WHO guidelines1,2. This indication should not be ignored as snake venom can spread through lymphatic routes in addition to blood3,4,5,6.There is a reply to this letter by Warrell, D.

。这一迹象不容忽视，因为蛇毒除了血液外还可以通过淋巴途径传播3,4,5,6。Warrell，D。对这封信有回复。

A. & Gutiérrez, J. M. Nat. Rev. Dis. Primers https://doi.org/10.1038/s41572-024-00544-8 (2024)..

A.&Gutiérrez，J.M.Nat.Rev.Dis。底漆https://doi.org/10.1038/s41572-024-00544-8（2024年）。。

ReferencesWHO Regional Office for South-East Asia. Guidelines for the management of snakebites 1st edn (WHO, 2010).WHO Regional Office for South-East Asia. Guidelines for the management of snakebites 2nd edn (WHO, 2016).Gutiérrez, J. M. et al. Snakebite envenoming. Nat. Rev. Dis. Primers 3, 17063 (2017).Article .

参考世卫组织东南亚区域办事处。蛇咬伤管理指南第1版（WHO，2010）。世卫组织东南亚区域办事处。蛇咬伤管理指南第二版（WHO，2016）。Gutiérrez，J.M.等人。毒蛇咬伤。自然版本Dis。引物317063（2017）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Evans, D. D. & Nelson, L. W. Treating venomous snakebites in the United States: a guide for nurse practitioners. Nurse Pract. 38, 13–22 (2013).Article

Evans，D.D。和Nelson，L.W。治疗美国毒蛇咬伤：护士从业人员指南。实习护士。38,13-22（2013）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Mora, J., Mora, R., Lomonte, B. & Gutiérrez, J. M. Effects of Bothrops asper snake venom on lymphatic vessels: insights into a hidden aspect of envenomation. PLoS Negl. Trop. Dis. 2, e318 (2008).Article

Mora，J.，Mora，R.，Lomonte，B。＆Gutiérrez，J.M。白杨蛇毒对淋巴管的影响：对毒液形成隐藏方面的见解。。托普。Dis。2，e318（2008）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

van Helden, D. F., Dosen, P. J., O’Leary, M. A. & Isbister, G. K. Two pathways for venom toxin entry consequent to injection of an Australian elapid snake venom. Sci. Rep. 9, 8595 (2019).Article

van Helden，D.F.，Dosen，P.J.，O'Leary，M.A。和Isbister，G.K。注射澳大利亚elapid蛇毒后毒液毒素进入的两条途径。科学。代表98595（2019）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Download referencesAuthor informationAuthors and AffiliationsEmergency Department, Chongqing University Fuling Hospital, School of Medicine, Chongqing University, Chongqing, ChinaJin-Long WangAuthorsJin-Long WangView author publicationsYou can also search for this author in

下载参考文献作者信息作者和附属机构重庆大学涪陵医院急诊科，重庆大学医学院，重庆，中国

PubMed Google ScholarCorresponding authorCorrespondence to

PubMed谷歌学者通讯社

Jin-Long Wang.Ethics declarations

王金龙。道德宣言

Competing interests

相互竞争的利益

The author declares no competing interests.

作者声明没有利益冲突。

Rights and permissionsReprints and permissionsAbout this articleCite this articleWang, JL. Antivenom treatment for snakebite envenoming.

权利和许可打印和许可本文引用本文Wang，JL。蛇咬毒液的抗蛇毒治疗。

Nat Rev Dis Primers 10, 59 (2024). https://doi.org/10.1038/s41572-024-00543-9Download citationPublished: 22 August 2024DOI: https://doi.org/10.1038/s41572-024-00543-9Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Nat Rev Dis引物10,59（2024）。https://doi.org/10.1038/s41572-024-00543-9Download引文发布日期：2024年8月22日OI：https://doi.org/10.1038/s41572-024-00543-9Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

Provided by the Springer Nature SharedIt content-sharing initiative

由Springer Nature SharedIt内容共享计划提供