患者男,38岁,厨师,因左手示指被圆斑蝰蛇咬伤4d于2012年6月5日18时由外院转入。患者于2012年6月1日11时许被蛇咬伤左手示指,当时左上肢肿痛,伴呕吐,呕吐物为胃内容物,无排黑便、血尿,无气促,到当地医院就诊,核对图谱为圆斑蝰蛇,先后予局部封闭、清创,14时使用抗蝮蛇毒血清9000U,起病第2天出现尿量减少,血肌酐逐渐上升,伴皮下淤 Patient male, 38 years old, chef, biting his left hand with a biting viper 4d On June 5, 2012, at 18:00, he was transferred from the outer court. At 11 am on June 1, 2012, the patient was bitten by a snake. When the left upper limb was sore, accompanied by vomit, the vomit was stomach contents, no melena, hematuria, no breath, and visited the local hospital, Check the map for the spot viper, has to be partially closed, debridement, 14:00 the use of anti-snake venom serum 9000U, the onset of the first two days decreased urine output, serum creatinine gradually increased, with subcutaneous silt