Smith R P, Gosselin R E
J Occup Med. 1979 Feb;21(2):93-7. doi: 10.1097/00043764-197902000-00008.
Poisoning by hydrogen sulfide has been recognized as an occupational hazard for at least two centuries. The development of alternative sources of energy in North America may increase the incidence of this medical emergency in the future. Until recently, no specific antidote to sulfide was recognized. We have compared sulfide poisoning to cyanide poisoning and documented recent findings that indicate many similarities between the two. The therapeutic induction of methemoglobinemia, as by the intravenous administration of sodium nitrite, has both protective and antidotal effects against sulfide as well as against cyanide in laboratory animals. This procedure has been used successfully in at least one severe human case of sulfide poisoning. Industries at risk should be prepared to initiate this form of therapy in addition to the usual measures for cardiopulmonary resuscitation. No evidence exists to suggest that sulfide poisoning results in an impairment of the oxygen transport capability of blood. On the other hand, some victims of hydrogen sulfide poisoning exhibit frank cyanosis, suggesting that the respiratory tract obstruction is more common in this condition than is generally recognized. Suction of the upper tract and the administration of oxygen may be important ancillary procedures to the administration of sodium nitrite.
硫化氢中毒至少在两个世纪以来一直被视为一种职业危害。北美替代能源的发展可能会在未来增加这种医疗急症的发生率。直到最近，还没有被认可的针对硫化物的特效解毒剂。我们将硫化物中毒与氰化物中毒进行了比较，并记录了最近表明两者之间存在许多相似之处的研究结果。在实验动物中，通过静脉注射亚硝酸钠等方式治疗性诱导高铁血红蛋白血症，对硫化物和氰化物都具有保护和解毒作用。该方法已在至少一例严重的人类硫化物中毒病例中成功应用。面临风险的行业除了采取常规的心肺复苏措施外，还应准备好启动这种治疗方式。没有证据表明硫化物中毒会导致血液氧运输能力受损。另一方面，一些硫化氢中毒受害者出现明显的紫绀，这表明呼吸道梗阻在这种情况下比普遍认为的更为常见。对上呼吸道进行抽吸和给予氧气可能是亚硝酸钠给药的重要辅助程序。
