毒蛇咬伤致脑梗死一例报告并文献复习

摘要

Objective To investigate the clinical manifestations,pathogenesis and prognosis of patients with cerebral infarction induced by poisonous snake bite. Methods A retrospective analysis was made on the clinical data of a patient with cerebral infarction induced by snake bite who was admitted into the Affiliated Hospital of Luzhou Medical College,and relevant literature in China and abroad was collected and analyzed. Results The onset of cerebral infarction of patients bit by poisonous snakes usually happens within 2 days after snake bite,and the high _ incidence period of cerebral infarction begins at 4 h after snake bite. Infarction nidus occurs in either anterior circulation or posterior circulation,not both. The patients have low mRS score and high case fatality rate on average,and children and adolescents have poor prognosis. Conclusion The pathogenesis of cerebral infarction induced by poisonous snake bite is complicated,and the patients have high disability rate and case fatality rate and poor prognosis,and its effective clinical treatment needs to be further researched.%目的：了解毒蛇咬伤致脑梗死患者的临床表现、发病机制及预后。方法回顾性分析泸州医学院附属医院收治的1例毒蛇咬伤致脑梗死患者的临床资料，并对国内外相关文献进行收集和分析。结果毒蛇咬伤患者的脑梗死发病时间多为咬伤后2 d 内，咬伤后4 h 为高发期；梗死灶在前循环和后循环均有发现，但无同时累及前、后循环者；患者平均改良 Rankin 量表（mRS）评分较低，死亡率较高，儿童和青少年预后较差。结论毒蛇咬伤致脑梗死的发病机制较为复杂，致残、致死率较高，患者预后较差，有效的临床治疗尚有待进一步研究。