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| The rational approach of block treatment with chymotrypsin injection for Chinese cobra bites |
| Huang Zhou, Wang Wei, Li Tian, Huang Dong-ling, Li Jun, Wang Fan |
| Department of Emergency, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China |
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Abstract Objective: To approach the rationality of block treatment with chymotrypsin for Chinese cobra bites. Methods: Mixed Chinese cobra venom with different concentrations of chymotrypsin, and used biuret reaction to measure the remnant venom. Rats were randomly divided into 8 groups, which were respectively in molding groups (injected by sterile water or Chinese Cobra venom), block treatment groups(included match groups and groups of block treatment with chymotrypsin after 30 min or 60 min) & groups of the influence by injected in different concentrations of chymotrypsin(21 U/mL, 40 U/mL or 400 U/mL). The area of subcutaneous hemorrhage was recorded and analyzed. The mortality comparison was carried on between the experimental groups (block treatment) and the control group(Chinese cobra venom injection). Results: In vitro experiment, there was correlation between the extinction and the chymotrypsin dosage with different balance endpoint. The subcutaneous hemorrhage areas were respectively (3.05±0.12)cm2 and (3.38±0.10) cm2 30 min and 60 min after block treatment, both of them were smaller than(4.04±0.12) cm2 of blank control group(P<0.05 for both). Chymotrypsin could directly result in subcutaneous hemorrhage, and the area had a positive correlation associated with the concentration of chymotrypsin(R=0.966, P<0.01). The mortality in the block treatment group and control group respectively were 44.0% and 52.0%, but the difference showed no statistical significance(P＞0.05). Conclusion: The dosage of chymotrypsin recommended by clinic in block treatment after Chinese cobra bites does not reach the mark of inactivating the Chinese cobra venom; furthermore it increases the risk of subcutaneous hemorrhage. The rationality of chymotrypsin for the treatment of Chinese cobra bites needs to be supported by further clinical investigations or evidence-based medicine.
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Received: 08 January 2017
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Corresponding Authors:
Wang Wei, E-mail: 13507715528@163.com
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