烧伤患者的氰化物中毒

Cyanide toxicity in burned patients.

作者信息

Silverman S H, Purdue G F, Hunt J L, Bost R O

机构信息

Department of Surgery, University of Texas (Southwestern Medical School) Health Science Center, Dallas 75235.

出版信息

J Trauma. 1988 Feb;28(2):171-6. doi: 10.1097/00005373-198802000-00007.

DOI:10.1097/00005373-198802000-00007

PMID:3346915

Abstract

The role of cyanide (CN) in smoke inhalation injury has been the subject of investigation for many years. Prospective evaluation of serum CN, thiocyanate (the primary metabolic product of CN), and carboxyhemoglobin (COHb) in patients suspected by history of having smoke inhalation injury was performed in 144 patients. Eight of 12 patients with "lethal" CN levels (greater than 1.0 mg/L) died. All had sublethal levels of COHb. A separate group of patients who were DOA following fatal burn injuries were also studied. Lethal CN levels were found in 12 of 14 victims with lethal COHb levels and in 14 of 20 victims with sublethal COHb levels. The results show that elevated CN levels are frequent in patients with smoke inhalation and suggest that cyanide toxicity is a contributor to severe inhalation injuries. In some cases, CN was the primary measured toxicant.

摘要

氰化物（CN）在烟雾吸入性损伤中的作用多年来一直是研究的课题。对144例因有烟雾吸入性损伤病史而被怀疑的患者进行了血清CN、硫氰酸盐（CN的主要代谢产物）和碳氧血红蛋白（COHb）的前瞻性评估。12例CN水平“致死”（大于1.0 mg/L）的患者中有8例死亡。所有患者的COHb水平均为亚致死水平。还对另一组因致命烧伤而到达医院时已死亡（DOA）的患者进行了研究。在14例COHb水平致死的受害者中有12例发现了致死性CN水平，在20例COHb水平亚致死的受害者中有14例发现了致死性CN水平。结果表明，烟雾吸入患者中CN水平升高很常见，提示氰化物毒性是严重吸入性损伤的一个促成因素。在某些情况下，CN是主要检测到的毒物。