对乙酰氨基酚中毒：重症监护医生的最新资讯
Acetaminophen poisoning: an update for the intensivist.
作者信息
Dargan Paul I, Jones Alison L
机构信息
Specialist Registrar in Medicine and Clinical Toxicology, National Poisons Information Service, Guy's & St Thomas' NHS Trust, London, UK.
出版信息
Crit Care. 2002 Apr;6(2):108-10. doi: 10.1186/cc1465. Epub 2002 Mar 14.
Abstract
Acetaminophen overdose is common and can result from deliberate/nonstaggered or accidental/staggered ingestion. Patients presenting within 24 h of an acetaminophen overdose can safely be managed on medical wards. Early management of nonstaggered overdose is guided by the plasma acetaminophen concentration, whereas management of accidental/staggered ingestion is guided by ingested dose. Ingested dose and time from ingestion to presentation are important prognostic factors in accidental/staggered ingestion. Acetaminophen-induced acute liver failure (ALF) requires meticulous supportive care in an intensive care unit (ICU), with early identification and transfer of patients who are likely to require liver transplantation to a specialist liver centre. The modified King's College Hospital criteria (incorporating lactate into the traditional criteria) represent the best tool for identifying patients who require transplantation.
摘要
对乙酰氨基酚过量服用很常见，可能是故意/一次性或意外/分次摄入所致。对乙酰氨基酚过量服用后24小时内就诊的患者可在普通病房安全治疗。一次性过量服用的早期治疗以血浆对乙酰氨基酚浓度为指导，而意外/分次摄入的治疗则以摄入剂量为指导。摄入剂量以及从摄入到就诊的时间是意外/分次摄入的重要预后因素。对乙酰氨基酚所致急性肝衰竭（ALF）需要在重症监护病房（ICU）进行精心的支持治疗，早期识别并将可能需要肝移植的患者转至专科肝脏中心。改良的国王学院医院标准（将乳酸纳入传统标准）是识别需要移植患者的最佳工具。
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