Schiffl H, Weidmann P, Weiss M, Massry S G
Miner Electrolyte Metab. 1982 Jan;7(1):28-35.
External burns with chromic acid have been fatal even in cases with corrosions covering less than 10% of the body surface area. We observed a 19-year-old man with third-degree burns and chromium intoxication following accidental contact of both legs with chromium acid solution. The initial course was characterized by serum chromium levels known to be usually lethal (220 micrograms/100 ml), complete anuria, hepatic damage and progressive anemia. Aggressive peritoneal dialysis with a total duration of 252 h between the 4th and 22nd day after exposure caused a progressive decrease in serum chromium levels and resulted in a complete recovery after 35 days. The comparative efficacy of peritoneal versus hemodialysis in chromium removal was evaluated in 5 patients with acute renal failure who were treated with peritoneal dialysis and in 6 patients with end-stage renal failure who underwent hemodialysis. Following intravenous injection of 500 muCi51CrCl3 chromium clearance averaged 0.8 +/- 0.3 ml/min and 2.5 +/- 0.8 ml/min during peritoneal dialysis (n = 50) or hemodialysis (n = 24), respectively. It is concluded that hemodialysis is about 3 times as effective as peritoneal dialysis in chromium removal per unit of time. However, the possibility of applying uninterrupted peritoneal dialysis during the first few days suggests that this method is at least equivalent to hemodialysis for treatment in the initial stage of chromium intoxication.
即使铬酸造成的体表腐蚀面积小于10%，外部铬酸烧伤也可能致命。我们观察了一名19岁男性，其双腿意外接触铬酸溶液后出现三度烧伤和铬中毒。病程初期的特点是血清铬水平通常达到致死量（220微克/100毫升）、完全无尿、肝损伤和进行性贫血。在接触后的第4天至第22天期间，进行了总计252小时的积极腹膜透析，使血清铬水平逐渐下降，并在35天后完全康复。对5例接受腹膜透析治疗的急性肾衰竭患者和6例接受血液透析的终末期肾衰竭患者，评估了腹膜透析与血液透析在清除铬方面的相对疗效。静脉注射500微居里51CrCl3后，腹膜透析（n = 50）和血液透析（n = 24）期间的铬清除率分别平均为0.8±0.3毫升/分钟和2.5±0.8毫升/分钟。结论是，血液透析在单位时间内清除铬的效果约为腹膜透析的3倍。然而，在最初几天应用持续腹膜透析的可能性表明，这种方法在铬中毒初期治疗中至少与血液透析等效。
