大剂量异丙嗪急性中毒成功救治一例并文献复习

High-Dose Promethazine Poisoning:A Case Report and Literature Review

目的提高对异丙嗪急性中毒的认识,了解其临床特点及抢救治疗措施。方法分析1例大剂量异丙嗪急性中毒患者的临床资料和成功救治方法,并结合相关文献进行分析。结果患者大剂量异丙嗪中毒后出现意识障碍、椎体外系症状、肝功能损害、血糖升高、心动过速、心肌酶升高等表现,予以洗胃、利尿、导泻、保护重要脏器功能和早期多次血液净化治疗(血浆置换和血液灌流)后患者痊愈。结论异丙嗪中毒临床表现特殊,治疗上目前无特效解毒剂,常规救治措施联合早期多次血液净化治疗可极大提高抢救成功率,值得推广。

Objective To improve understanding of clinical features and treatment for promethazine poisoning. Methods Clinical data and successful treatment of a case of high - dose promethazine poisoning were analyzed and related literature reviewed. Results Disturbance of consciousness, cxtrapyramidal symptoms, liver dysfunction, high blood sugar, tachycardia and elevated cardiac enzymes appeared in the patient with high - dose promethazine poisoning. The patient recovered after rescue measures such as gastric lavage, diuresis, catharsis, protection of vital organs and early multiple blood purification treatment （ plasma exchange and hemoperfusion）. Conclusion The clinical performance of promethazine poisoning is special and there is no specific antidote currently. Conventional rescue measures combined with early multiple blood purification treatment, which can greatly improve rescue rate, is worth generalizing.