Rắn độc và chế tạo huyết thanh kháng nọc điều trị đặc hiệu tại việt nam

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Tác giả: Khắc Quyến Lê, Doanh Tuyên Thái, Xuân Kiếm Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại: 378.597 Higher education

Thông tin xuất bản: Y học Việt Nam, 2014

Mô tả vật lý: 34-37

Bộ sưu tập: Metadata

ID: 559832

Introduction: At APAMPT, 2010, President of IST stated: "it is estimated that there may be about 5 million snakebites per year in the World, out of which 125,000 victims die as a result, about haft of these deaths occur in Asia." There are about 30,000 snakebites annually in Vietnam. This is the big medical problem in tropical areas, but was neglected in some where. Response to this situation, since 1990 the research program of snake bites and developmeot anti venom for clinical specific treatment has been established successfully in Vietnam. Materials and Methods: - Materials: All most of snakes bit the patients were brought to hospitals and living snakes in the field were studied together with clinic. Their venoms were milked to produce specific antigen for each specie. Horses were used for immunization to take plasma for antivenom (AV) production . Pepsin, ammonium sulfate, HO, NaOH... were used for purification of AV, Rabbits, Guinea-pigs, White mice thioglycollate and Saboraud media... were used for quality control of AV. - Methods: Identification of snakes, immunization, purification and quality control techniques for AVF(ab)2 (WHO Guidelines for the Production Control and Regulation of Snake Antivenom Immunoglobulins, October 2008). Antigen making (David Warrell and D. Theakston and WHO). The Results: Identification oftwo snake families of medical importance content 9 main species: Elapidae (Naja kaouthia, Naja siamensis, Naja atra, Ophiophagus hannah, Bungarus candidus, Bungarus multicinctus, Bungarus faciatus). Viperidae (Calloselasma rhodostoma, Trimeresurus). They are the most dangerous and common snakes due to 30,000 cases of bites each year in VN. Anti venom development: 07 kinds of AVs (N. kaouthia, N. atra, Ophiophagus hannah, Bungarus candid us, Bungarus multicinctus, Calloselasma rhodostoma) weremade and met the quality standards of National Institute for control of vaccine and biologicals, VN and WHO Guidelines for the Production Control and Regulation of Snake Antivenom Immunoglobulins.. The controlled clinical trials of new AVs for three thousand patients, which envenomed by these snakes with the good results. For the patients were envenomed by Elapidae family: The patients in AV treated group had a significantly shorter duration of neuro- muscular paralysis (from over one month reduced to two days) and the rate of ventilationassociated pneumonia was significantly lower (from 90 percent to 1.0 percent). For the patients were envenomed by Viperidae family: Coagulation disorders were returned to normal within 24 hrs in AV treated group, compared with 10 days in not AV treated group accordlnglybefore. The mortality in severe envenoming groups due to both of snake families was reduced (from 22 percent to 1.5 percent). The rate of AV adverse reactions was (7.4 percent.). It is less than WHO Guidelines (15 percent). Conclusions: Two snake families of medical importance in Vietnam were identified. Seven kinds of AVs F(ab)2 were made and met the quality control standards of VN and WHO. The efficacy and safety of these new AVs have been demonstrated clearly in the controlled clinical trials of patients bitten by these snakes accordingly.
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