Moretti S, Jouvet P, Schleiermacher G, Hubert P, Doz F, Zucker J M, Cloup M
Service de réanimation pédiatrique, hôpital Necker-Enfants-Malades, Paris, France.
Arch Pediatr. 1996 Mar;3(3):258-60. doi: 10.1016/0929-693x(96)81305-4.
Cyanosis associated to low oxygen saturation may reveal hemoglobin pathology.
A 3 year-old child had a nephroblastoma with pleural effusion. He suddenly developed persistent cyanosis despite pleural effusion drainage; transcutaneous and measured oxygen saturations were low and PaO2 on arterial blood gases was high. Methemoglobinemia was diagnosed, due to prilocaine-lignocaine cream used for local anesthesia, associated to partial G6PD deficiency. The methemoglobinemia disappeared after methylene blue treatment.
Cyanosis with low oxygen saturation and high or normal PaO2 should lead to the search of a hemoglobin pathology, especially methemoglobinemia, by appropriate methods.
与低氧饱和度相关的发绀可能提示血红蛋白病变。
一名3岁儿童患有肾母细胞瘤并伴有胸腔积液。尽管进行了胸腔积液引流，但他突然出现持续发绀；经皮测量和实测的氧饱和度均较低，而动脉血气分析中的PaO₂ 较高。诊断为高铁血红蛋白血症，原因是用于局部麻醉的丙胺卡因 - 利多卡因乳膏，与部分葡萄糖 - 6 - 磷酸脱氢酶（G6PD）缺乏有关。经亚甲蓝治疗后，高铁血红蛋白血症消失。
氧饱和度低且PaO₂ 高或正常的发绀情况应通过适当方法排查血红蛋白病变，尤其是高铁血红蛋白血症。
