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使用硝普钠(Sodium nitroprusside,SNP)可产生代谢性酸中毒、中毒及死亡,这些毒性作用与SNP 的代谢产物一氰的作用有直接关系。一、输注SNP 期间,氰、硫氰化物及维生素B_(12)(Vit B_(12))的改变:动物实验及临床研究证明,在氰代谢中可能有钴胺(Vit B_(12))~*参加,因此在输注SNP 时,不仅要注意SNP 对氰和硫氰化物浓度的影响,同时也要注意SNP 对血清VitB_(12)浓度的影响。Fahmy 在控制性低压麻醉研究中,使用SNP 输注的实验组,每个患者总剂量平均为50.2±9.1mg(0.89±0.16mg/kg),输注速度为4.3±0.9μg/kg/分,低压持续时间为207±11分。发现SNP 输注3小时后血氰含量(65.7
The use of sodium nitroprusside (SNP) can produce metabolic acidosis, poisoning and death, and these toxic effects are directly related to the role of SNP metabolite-cyanogen. Changes of Cyanide, Thiocyanide and Vit B 12 During the SNP Infusion: Animal experiments and clinical studies have shown that there may be a Cobalamin (Vit B 12) in cyanide metabolism, ~ *. Therefore, not only the effect of SNP on the concentration of cyanide and thiocyanate, but also the effect of SNP on the concentration of serum VitB_ (12) should be noticed during SNP infusion. In a controlled hypotension study, Fahmy used a SNP-infused experimental group with a mean total dose of 50.2 ± 9.1 mg (0.89 ± 0.16 mg / kg) and an infusion rate of 4.3 ± 0.9 μg / kg / min for each patient, The duration of low pressure was 207 ± 11 minutes. After 3 hours of SNP infusion, the level of blood cyanide was found (65.7%)