Snyder J W, Safir E F, Summerville G P, Middleberg R A
Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA.
Am J Emerg Med. 1995 Mar;13(2):199-203. doi: 10.1016/0735-6757(95)90094-2.
Exposure to hydrogen sulfide (H2S) has been associated with death as well as survival following coma with or without hypoxic brain damage. The release of H2S at a beachfront construction site led to the emergency evaluation and treatment of 37 people, with six admissions and one death. At least one victim, who underwent extensive therapy with hyperbaric oxygen, developed persistent neurological sequelae. Despite increased awareness of the potentially life-threatening consequences of exposure to H2S, significant poisoning continues to occur, even in workplaces where the hazards are well-known and can be avoided. Recommended therapy includes nitrites, hyperbaric oxygen, and supportive care, but documentation of efficacy is lacking. Because patients with chronic neurological sequelae after acute H2S exposure continue to be reported, we suggest that any survivor of H2S poisoning who presents in coma or who manifests objectively verifiable evidence of neurotoxicity on physical examination or lab testing should undergo baseline and annual neurological and neuropsychological testing for at least five years. This approach could standardize and enhance our knowledge of, and ability to detect, the subtle but permanent alterations of central nervous system function that follow H2S exposure.
接触硫化氢（H₂S）与昏迷后死亡以及存活均有关联，无论有无缺氧性脑损伤。在一个海滨建筑工地硫化氢的释放导致了37人接受紧急评估和治疗，其中6人住院，1人死亡。至少有一名接受了高压氧广泛治疗的受害者出现了持续性神经后遗症。尽管人们对接触H₂S潜在的危及生命后果的认识有所提高，但严重中毒仍在继续发生，即使在那些危害众所周知且可避免的工作场所也是如此。推荐的治疗方法包括使用亚硝酸盐、高压氧和支持性护理，但缺乏疗效记录。由于急性H₂S暴露后出现慢性神经后遗症的患者仍不断有报告，我们建议，任何H₂S中毒幸存者，若出现昏迷，或在体格检查或实验室检测中表现出客观可证实的神经毒性证据，应至少连续五年接受基线及每年一次的神经学和神经心理学检测。这种方法可以规范并增强我们对H₂S暴露后中枢神经系统功能细微但永久性改变的认识及检测能力。
