MỘT SỐ YẾU TỐ LÂM SÀNG LIÊN QUAN ĐẾN MỨC ĐỘ HOẠI TỬ NGÓN TAY DO RẮN HỔ MANG CẮN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To describe and analyze clinical factors that were significant prognostic indicators of the severity of digit necrosis caused by cobra snake. Subjects and methods: A cross-sectional study was conducted on 52 patients with finger necrosis due to cobra snake bites at Bach Mai Hospital. Results: Among the patients, 21 cases (40.4%) were classified as having superficial necrosis, while others (59.6%) had deep necrosis. The proportion of male patient made up nearly four fifths and almost patient were in working age. There was no significant difference between the two groups regarding the identified cobra species, chronic disease prevalence, or first-aid methods used. The median time to receive antivenom therapy was within 6 hours after the bite, and the median time to surgical intervention was 5 days. Local symptoms such as erythema and numbness were more frequent in the deep necrosis group (p<0.05). The area of necrosis affecting more than half of the finger circumference was 18.3 times higher in the deep necrosis group compared to the superficial group (p=0.01). Conclusion: Patients with finger necrosis accompanied by symptoms such local numbness and redness, especially the necrotic area covers more than half of the finger's circumference, were at high risk of tendon and bone exposure after debridement, making finger preservation challenging.