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目的:探讨注射用硝普钠(SNP)与5%葡萄糖注射液或0.9%氯化钠注射液配伍后使用时间延长至26 h的安全性。方法:将183例高血压危象患者随机分为6组,A、B、C组分别输注配制4 h内(A组,n=30)、12~14 h内(B组,n=31)、24~26 h内(C组,n=32)的SNP 5%葡萄糖注射液,D、E、F组分别输注配制4 h内(D组,n=28)、12~14 h内(E组,n=29)、24~26 h内(F组,n=33)的SNP 0.9%氯化钠注射液。检测各组患者血液中硫氰酸盐(SCN)、氰化物(CN)含量,并同时进行血气分析,记录SNP的用量;对配制后26 h的SNP注射液中CN含量进行检测。结果:SNP注射液中CN含量小于0.000 4%。6组患者中:不同时间段SNP的输入量及血浆中SCN、CN含量和全血中CN含量均在正常范围内,同一时间段组间比较无统计学意义(P>0.05);SNP输注前后血气分析值均在正常范围内,且组间、组内比较均无统计学意义(P>0.05)。结论:按常规配制,SNP注射液26 h内是稳定的,临床上延长SNP注射液使用时间至26 h是可行的。
Objective: To investigate the safety of sodium nitroprusside (SNP) injections with 5% dextrose injection or 0.9% sodium chloride injection for prolonged use up to 26 hours. Methods: A total of 183 cases of hypertensive crisis were randomly divided into 6 groups. Groups A, B and C were infused within 4 h (group A, n = 30), within 12 to 14 h (group B, n = 31 ), SNP 5% glucose injection in group C (n = 32) within 24-26 h and groups D, E and F were infused within 4 h (group D, n = 28) (Group E, n = 29) and SNP 0.9% sodium chloride injection within 24-26 h (group F, n = 33). The contents of thiocyanate (SCN) and cyanide (CN) in the blood of each group were detected. At the same time, blood gas analysis was performed to record the amount of SNP. The content of CN in the SNP injection at 26 hours after preparation was measured. Results: The content of CN in SNP injection was less than 0.000 4%. In the 6 groups of patients, the input of SNP and the levels of SCN and CN in plasma and CN in whole blood were within the normal range at different time points. There was no significant difference between the two groups in the same time (P> 0.05) Blood gas analysis before and after the value were within the normal range, and between groups, no significant difference between groups (P> 0.05). CONCLUSIONS: SNP injection is stable within 26 h according to routine formulation. It is feasible to prolong the use of SNP injection to 26 h.