ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH SIÊU ÂM TỔN THƯƠNG TẠI CHỖ Ở BỆNH NHÂN BỊ RẮN HỔ CẮN

Abstract

Objective: to describe the clinical and ultrasound characteristics of local effects on patients envenomed by cobra snakes. Methods: the observational prospective study included 104 patients bitten by cobra snakes treated at the Poison Control Center of Bach Mai Hospital from July 2022 to October 2023. Results: mean age was 50,9±14,1 years old, mostly male patients. The common bites were at the digits. Local signs were pain (100%), swelling (100%), fang marks (71,2%), blisters (50%), skin necrosis (90,4%) and mild compartment syndrome (12,5%). POCUS revealed fluid-filled collection (36.5%), tendon sheath edema (83,7%), subcutaneous edema (100%) 2,5 times more than the normal limb, muscle edema (35,5%) 1,07 times more than the normal limb, extraneous body (1%). Limb edema was mainly SCE edema, and the contribution of muscle edema is minimal. There was a positive correlation between SCE and clinical distant spread (p < 0,001 and r = 0,973). SCE often appeared ealier than skin manifestations. The difference between the two measurements suggested the local damage progressing. Conclusion: POCUS provided more information of the local effects caused by cobra bites.