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제초제 중독으로 유발된 메트헤모글로빈혈증 환자에서 고용량 비타민 C 치료 1례
선경훈 ( Kyung Hoon Sun ),김준규 ( Jun Kew Kim ),류창연 ( Chang Yeon Ryu ),김서진 ( Seo Jin Kim ),조현규 ( Hyeon Kyu Jo ),유태호 ( Tae Ho Yoo ),박용진 ( Yong Jin Park ),김선표 ( Sun Pyo Kim ) 대한임상독성학회 2017 대한임상독성학회지 Vol.15 No.2
Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.