Merigian Kevin S, Blaho Kari E
Department of Obstetrics and Gynecology, University of Tennessee, Memphis, Cordova, TN 38018, USA.
Am J Ther. 2002 Jul-Aug;9(4):301-8. doi: 10.1097/00045391-200207000-00007.
Oral activated charcoal (OAC) is a universally accepted treatment of the overdose patient. Although the benefits of OAC have been suggested, there are no conclusive clinical data indicating that OAC affects outcome in overdose patients. This study was a prospective, randomized, controlled trial to determine the effects of OAC treatment in the self-poisoned adult patient. Adult patients presenting to the emergency department (ED) with a history of oral overdose were assigned to treatment with OAC (50 g) or supportive care only on an even-odd day protocol. Patients did not undergo gastric evacuation procedures in the ED. The outcome measures were clinical deterioration, length of stay in the ED or hospital, and complication rate. Over a 24-month period, 1479 patients were entered into the study. There were no significant differences in outcome parameters between the OAC treatment group and controls when comparing the length of intubation time, length of hospital stay, and the complication rates associated with the overdose. There was a higher incidence of vomiting and longer length of ED stay associated with OAC treatment. The results of this study indicated that oral drug overdose patients do not require gastric evacuation or charcoal administration. OAC provided no additional benefit to supportive care alone, was associated with a higher incidence of vomiting and a longer length of ED stay, and did not improve clinical outcome.
口服活性炭（OAC）是治疗药物过量患者普遍接受的方法。尽管OAC的益处已被提及，但尚无确凿的临床数据表明OAC能影响药物过量患者的预后。本研究是一项前瞻性、随机、对照试验，旨在确定OAC治疗对成人自我中毒患者的影响。因口服过量药物而到急诊科（ED）就诊的成年患者，按照奇偶数日方案，被分配接受OAC（50克）治疗或仅接受支持性治疗。患者在急诊科未接受洗胃程序。观察指标为临床病情恶化、在急诊科或医院的住院时间以及并发症发生率。在24个月的时间里，1479例患者纳入研究。比较插管时间、住院时间以及与药物过量相关的并发症发生率时，OAC治疗组与对照组的观察指标无显著差异。OAC治疗与呕吐发生率较高及在急诊科停留时间较长有关。本研究结果表明，口服药物过量患者无需洗胃或给予活性炭。OAC单独使用时对支持性治疗无额外益处，与呕吐发生率较高及在急诊科停留时间较长有关，且未改善临床结局。
