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洋地黄是临床治疗充血性心力衰竭的主要药物。按传统的用药方法,易发生中毒,甚至致死。本文参照有关资料,谈谈临床对洋地黄应用的新认识。一、中毒因素有人统计用洋地黄治疗的住院病人,约有10～20%发生中毒。一般认为,洋地黄中毒与下列因素有关:低血钾、低血镁、高血钙、酸硷平衡紊乱、缺氧、内源性或外源性交感神经张力增高、药物的相互作用。另外与心脏病性质及/或严重程度有关,急性心肌梗塞在24小时内、急性风湿热、细菌性心内膜炎、维生素B_1缺乏、贫血性心脏病、心肌炎、心肌病、肺心病、反复发作的心脏病晚期、难治性心力衰竭、缩窄性心包炎、严重二尖瓣狭窄、阵发性室性心动过速、房室传导阻滞、年老人、慢性肝炎、肾疾患、尿毒症、甲亢及甲减、脑卒中、糖尿病性昏迷等,均可导致洋地黄敏感性增高或不敏感而盲目加量,最终导致洋地黄中毒。因此,必须根据情况选择适当剂型剂量。
Digitalis is the main drug for clinical treatment of congestive heart failure. By traditional methods of medication, prone to poisoning, or even death. This article refers to the relevant information, talk about the clinical application of digitalis new understanding. A poisoning factor Some statistics with digitalis inpatient treatment, about 10 ~ 20% of the poisoning. Is generally believed that, digitalis poisoning and the following factors: hypokalemia, hypomagnesemia, hypercalcemia, acid-base balance disorders, hypoxia, endogenous or exogenous sympathetic tone, drug interactions. In addition, the nature and / or severity of heart disease, acute myocardial infarction within 24 hours, acute rheumatic fever, bacterial endocarditis, vitamin B_1 deficiency, anemia, myocarditis, cardiomyopathy, pulmonary heart disease, recurrent Advanced heart disease, refractory heart failure, constrictive pericarditis, severe mitral stenosis, paroxysmal supraventricular tachycardia, atrioventricular block, the elderly, chronic hepatitis, kidney disease, uremia, Hyperthyroidism and hypothyroidism, stroke, diabetic coma, etc., can lead to digitalis increased sensitivity or insensitivity and blindly added, eventually leading to digitalis poisoning. Therefore, you must choose the appropriate dose based on the situation.