Korean Journal of Nephrology 1984;3(1):34-41.

사교상에 (蛇咬傷) 의한 신병변에 (腎病變) 관한 임상적 (臨床的) 연구 (硏究)

김성권 ( 金聖權 ) , 윤성 ( 尹成 ) , 안규리( 安圭里 ) , 이정상 ( 李正相 )

Abstract

In Korea, three kinds of vipers cauae venomous venomous snake-bite accidents mostlp in Summcr. They are A, blomboffi blomhoffi, A. caliginoaus and A. -saxstilis, Following results were obtained by analysing clinical manifeatation, physical examinatibn :and laboratory findings. 1) There was a total of 189 patients who visited SNUH owing to snake-bite and 37 patients(19%') of them were admitted. 2) Snakebite accidents were prevalent in summer(62%) and more frequent in male(77 %), Thel most common bitten part of body was on fingrs '(50. 2%) Rate of complication was the highest with pati- ent bitten on left lower extremit A. blomhoffi 'blomhoffi was found to be tha highest cause of ven- omous snake-bite incidence among patienta and A, liginosus was indirectly confirmed to be the most 'toxic venomous snake. 3) Local manifeatation were local edems(94%), ph!n(73%) and discoloration(21%), Systemic man- ifestations were visual disturbance(13%) reddish urine(7 %) abdominal pain(4%) oliguria(4%) and ptosis(3%). 4) Main complication was summerised as acute .renal failure, bleeding tendency, neurotoxicity and .1ocal necrosis. 5) The patients were grouped according to renal .involvement. Renal involvement was defined ss those patients with hematuria, pyuria, proteinuria, proteinuria, asotemia or combination of these, snd 'they were found to be 54 patients. 6) The renal involved group was found to have I iollowing characteristics; delayed primary care, eld age, delayed antivenin injection and the more toxic enake kind being A. caliginoeus in epidemi- ologic aspect, more frequent complication and more severe clinicaI course in clinical aspect. 7) Generally, snskebite in SNUH csses showed mild clinical course except in 8 cases. Those 8 cases were observed to have acute renal failure, such as severe proteinuria, severe hematuria, hypocalcemia, hyperphosphatemia, increased BUN/Cr and metabo- lic acidosis and common characteristics observed in those patients with acute renal failure were also old age, delayed primary care, delayed antiv- enin injection, upper extrtmity as bitten part, hy- potension and bleeding tendency.