ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHI BỊ RẮN CHÀM QUẠP CẮN TẠI BỆNH VIỆN NHI ĐỒNG 1

Abstract

Objectives: Determination of clinical and sub-clinical characteristics of children with malayan pit viper bites hospitalized in Children hospital 1. Methods: Descriptive study was conducted on 54 medical records of children with snake bites hospitalized in Children hospital 1 from 01/01/2011 to 31/12/2020. Results: Nearly 100% of cases of swelling and pain immediately, toxic hook marks 72.2%. The incidence of infection and wound necrosis was quite high (37.0% and 38.9%). 44.4% appeared blisters and when there were blisters, 100% had hemorrhages in blisters. There is a correlation between blisters, infections, necrosis with the degree of intoxication (p < 0.001). 55.6% bruising, 46.3% bleeding, 46.3% skin hemorrhaging, gum bleeding 14.8%, digestive bleeding 1.9%, oliguria (1.9%), lowering blood pressure (1.9%) mainly seen in patients with severe infection. There is a correlation between bruising, bite bleeding, skin hemorrhage with a degree of intoxication (p < 0.001). The wound spreads through 2 joints by 55.5%. Blood clot disorder is a common manifestation of 94.6%, of which DIC accounted for 57.5% with fibrinogen down < 1g/L (59.3%), prolonged PT (53.7%), INR > 1.5 (46.3%), platelet < 150,000/mm³ (40.7%), prolonged aPTT (35.2%). The change in blood clot function testing and the degree of toxicity have a statistically significant correlation, p < 0.001. Conclusions: In children with wound swelling spreading through 2 joints, the incidence of severe intoxication is 2.8 times higher (KTC 95%: 1.5 – 5.1), statistically significant difference, p < 0.001