印度红蝎（Mesobuthus tamulus）中毒心血管表现的管理。
Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus).
作者信息
Bawaskar H S, Bawaskar P H
机构信息
Bawaskar Hospital, Research Centre, Mahadi Raigad, Maharashtra, India.
出版信息
Br Heart J. 1992 Nov;68(5):478-80. doi: 10.1136/hrt.68.11.478.
OBJECTIVE
The efficacy of nifedipine and prazosin in combination or alone in the management of cardiovascular manifestations caused to Mesobuthus tamulus poisoning was investigated.
DESIGN
Observation and study.
SETTING
Hospital at Mahad, Maharashtra, India.
SUBJECTS
62 patients who had been stung by a red scorpion were admitted from January to December 1990: 18 with hypertension, 15 with supraventricular tachycardia, 11 with pulmonary oedema, and 18 with local pain at the site of sting but no systemic involvement. Two patients with massive life-threatening pulmonary oedema were given intravenous sodium nitroprusside.
RESULTS
The combination of nifedipine and prazosin was more successful in preventing myocardial damage in 16 patients with hypertension than was nifedipine alone in two other patients with hypertension. Prazosin alone helped to alleviate the cardiovascular manifestations in eight patients with pulmonary oedema and 15 with supraventricular tachycardia. One patient with pulmonary oedema died and two recovered after they were given intravenous sodium nitroprusside.
CONCLUSION
Nifedipine alone did not prevent myocardial damage unless the peripheral action of venom was blocked by prazosin.
目的
研究硝苯地平与哌唑嗪联合或单独使用对印度红蝎蛰伤所致心血管表现的治疗效果。
设计
观察性研究。
地点
印度马哈拉施特拉邦马哈德的医院。
研究对象
1990年1月至12月收治的62例被红蝎蛰伤的患者，其中18例患有高血压，15例患有室上性心动过速，11例患有肺水肿，18例仅蛰伤部位局部疼痛但无全身症状。两名患有严重危及生命的肺水肿患者接受了静脉注射硝普钠治疗。
结果
硝苯地平与哌唑嗪联合用药在预防16例高血压患者心肌损伤方面比单独使用硝苯地平治疗另外2例高血压患者更有效。单独使用哌唑嗪有助于缓解8例肺水肿患者和15例室上性心动过速患者的心血管表现。1例肺水肿患者死亡，2例接受静脉注射硝普钠治疗后康复。
结论
除非哌唑嗪阻断毒液的外周作用，否则单独使用硝苯地平不能预防心肌损伤。
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