title: Clinical features and treatment experience: a review of 292 Chinese cobra snakebites.
abstract: Although Chinese cobra snakebite is the most common type of snake venenation in China, it still lacks a comprehensive and systematic description. Hence, we aimed to study Chinese cobra bite cases with particular attention to demography, epidemiology and clinical profile. In this study, a total of 292 cases of Chinese cobra snakebite, presenting between January 1, 2008 and December 31, 2012, were retrospectively reviewed. To investigate the effect of treatment at different presentation times (time from snakebite to admission), the patients were divided into two groups: group A included 133 cases that presented <12 h after the bite; group B included 159 cases that presented ≥12 h after the bite. To assess the correlation between application of a tourniquet and skin grafting, the cases were re-divided into two groups according to whether or not a tourniquet was used after the snakebite: tourniquet group (n=220) and non-tourniquet group (n=72). The results showed that Chinese cobra snakebites were most commonly seen during the summer, in the upper limbs, and in males, young adults, and snake-hunters. Group A experienced milder intoxication than group B (P<0.001). The rate of skin grafting was significantly higher in the tourniquet group (20.0%, compared with 9.7% in the non-tourniquet group, P<0.05). The results of this study indicate that anti-cobra venom and swift admission (within 12 h of the snakebite) are recommended for Chinese cobra snakebite. Tourniquet use is not recommended.
authors.affiliation: Department of Emergency, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: weiwanggx@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Respiratory, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: chenquanfang555@163.com.
authors.forename: Quan-Fang
authors.initials: QF
authors.lastname: Chen
authors.affiliation: Department of Cardiology, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: yinruixing@163.com.
authors.forename: Rui-Xing
authors.initials: RX
authors.lastname: Yin
authors.affiliation: Department of Emergency, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: zhujijin63@vip.sina.com.
authors.forename: Ji-Jin
authors.initials: JJ
authors.lastname: Zhu
authors.affiliation: Department of Emergency, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: 992642390@qq.com.
authors.forename: Qi-Bin
authors.initials: QB
authors.lastname: Li
authors.affiliation: Department of Emergency, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: kanggang130@163.com.
authors.forename: Hai-Hua
authors.initials: HH
authors.lastname: Chang
authors.affiliation: Department of Respiratory, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China. Electronic address: 305722025@qq.com.
authors.forename: Yan-Bi
authors.initials: YB
authors.lastname: Wu
authors.affiliation: Department of Emergency, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, 44106 OH, USA. Electronic address: edward.michelson@uhhospitals.org.
authors.forename: Edward
authors.initials: E
authors.lastname: Michelson
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D017815:Elapidae; D006801:Humans; D009336:Necrosis / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012909:Snake Bites / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000997:Antivenins
keywords: Chinese cobra; Clinical features; Snakebite; Treatment experience