| Abstract | Cilj istraživanja: Cilj istraživanja bio je prikazati koliko često se javlja kompartment sindrom koji nastaje nakon ugriza zmija otrovnica na području Splitsko-dalmatinske županije. Prikazano je liječenje kompartment sindroma, kao i načini liječenja otrovanja zmijskim otrovom.
Materijali i metode: Retrospektivno, kliničko epidemiološko istraživanje obuhvatilo je 15 pacijenata koji su razvili kompartment sindrom nakon ugriza zmije otrovnice od 1. siječnja 1986. godine do 31. prosinca 2019. godine. Svi su liječeni u Kliničkom bolničkom centru Split. Ispitanici su bili bolesnici svih dobnih skupina, od 1 do 80 godina.
Rezultati: Kompartment sindrom, kao najteža lokalna komplikacija nakon ugriza zmija otrovnica, nastao je u 3,1% bolesnika koje je ugrizla zmija otrovnica. Najveći broj kompartment sindroma bio je u svibnju (27%) i lipnju (27%). Kod svih bolesnika s kompartment sindromom razvili su se otok, crvenilo i podljev. Povećani i/ili bolni regionalni limfni čvorovi zabilježeni su u 80% bolesnika, povraćanje u 60%, proljev u 13% te tahikardija pri prijemu u 80% bolesnika. Paraliza ili pareza kranijalnih živaca očitovala se kao ptoza kapaka. Kompartment sindrom, kao najteža lokalna komplikacija nakon ugriza zmija otrovnica, javio se nakon ugriza zmije za gornji ekstremitet u 60% ispitanika, za donji ekstremitet u 33% ispitanika i 7% za ostale dijelove tijela. Većina pacijenata nije primijenila nijedan oblik samopomoći na terenu, a ostali su imobilizirali ud, stavili povez ili isisali otrov iz ugrizne rane. Antiviperini serum i antitetaničku profilaksu primili su svi ispitanici (100%). Svi ispitanici dobili su antibiotike i kortikosteroide i većina antihistaminike (93%). U svih ispitanika napravljena je fasciotomija kao tretman kompartment sindroma.
Zaključak: Na području Splitsko-dalmatinske županije od 1986. do 2019. godine ukupno je bilo 480 slučajeva ugriza zmija otrovnica. Od ukupnog broja ugrizenih osoba, u 15 pacijenata (3,1%) nastao je kompartment sindrom. Svim pacijentima napravljena je fasciotomija kao terapija za kompartment sindrom. |
| Abstract (english) | Objective: The aim of the study was to present the frequency of the development of the compartment syndrome after venomous snake bite in the Split-Dalmatia county. Ways of envenomation treatment and the treatment of compartment syndrome are also presented.
Materials and Methods: In this clinical and epidemiological study, 15 patients who developed compartment syndrome after a venomous snake bite, were included retrospectively from 1st January, 1986. to 31st December, 2019. All were treated at the University Hospital of Split. Subjects were patients of all ages, from 1 to 80 years.
Results: Compartment syndrome, as the most severe local complication after venomous snake bite, occurred in 3.1% of patients bitten by venomous snake. Most of the compartment syndromes developed after envenomation occurred in May (27%) and June (27%). All patients, who developed compartment syndrome, at the bite site developed swelling, redness and hematoma. Enlarged and/or painful regional lymph nodes were reported in 12 patients (80%), vomiting in 60%, diarrhea in 13%, and tachycardia in 80% of patients. Paralysis or paresis of the cranial nerves manifested as eyelid ptosis. Compartment syndrome, as the most severe local complication after envenomation, succeeding the snake bites on the upper extremity in 60% of subjects, on the lower extremity in 33% of subjects and 7% on the other parts of the body. Most of the patients who developed compartment syndrome did not apply any form of selfhelp, while others immobilized the limb, applied constricting band, or extracted venom out of the bite wound. All patients received the antivenom and tetanus prophylaxis. Also, all of received antibiotics and corticosteroids. All subjects underwent fasciotomy as a treatment for the compartment syndrome.
Conclusion: In the Split-Dalmatia county, from 1986. to 2019., there were 480 cases of venomous snake bite. Compartment syndrome developed in 15 patients (3,1%) of the total number of bitten patients. All patients underwent fasciotomy as a therapy for compartment syndrome. |
