在儿童中毒蛇咬后与死亡率相关的因素:一个范围审查
Lucy Guile1,2, Adrienne Lee1,2, José María Gutiérrez3
1Peninsula Medical School, University of Plymouth, Plymouth PL6 8BU, UK.
概括
儿童中毒死亡率与年轻年龄,延迟抗毒剂和损伤有关. 全球需要更多的研究来改善对这一脆弱群体的护理.
科学领域:
- 公共卫生 公共卫生
- 儿科医学 儿科医学
- 毒理学 毒理学 毒理学
背景情况:
- 毒蛇咬伤是全球重要的健康问题,不成比例地影响贫困的农村社区.
- 儿童代表了一个特别容易受到蛇毒害结果的影响的人口群.
- 现有的同行评审的证据是有限的,对Envenomed儿童的死亡因素.
研究的目的:
- 进行对同行评审的证据进行范围审查,这些证据是关于与患有蛇毒的儿童死亡率相关的因素.
- 确定有关该主题的可用研究的范围,类型和内容.
- 突出研究领域的地理差距.
主要方法:
- 使用MEDLINE和全球医学指数进行了全面的文献搜索.
- 包括的研究重点关注的是导致儿科蛇中毒病例死亡率的因素.
- 15篇文章满足了从623篇文章的初始搜索中获得的包含标准.
主要成果:
- 大多数被纳入的研究 (67%) 是在印度进行的,其他地区的代表性有限,如撒哈拉以南非洲和拉丁美洲.
- 确定死亡率的关键风险因素包括年轻的患者年龄,延迟使用抗毒剂和急性损伤.
- 在亚洲和大洋洲以外的高负担地区,可资格研究的稀缺性显著.
结论:
- 年轻的年龄,延迟的抗毒药和急性损伤是儿科蛇中毒的关键预后因素.
- 临床医生可以利用确定的不良预后因素来引导及时转诊到专门的儿科重症监护.
- 未来的研究应该优先考虑代表性不足的地理区域,以制定针对有毒儿童的综合性,基于证据的护理策略.
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