Bouma A W, van Dam B, Meynaar I A, Peltenburg H G, Walenbergh-van Veen M C M
Afd. Apotheek, Groene Hart Ziekenhuis, Postbus 1098, 2800 BB Gouda.
Ned Tijdschr Geneeskd. 2004 Aug 14;148(33):1642-5.
A 44-year-old female was found comatose after attempting suicide. Toxicological screening showed phenobarbital intoxication. The patient was treated symptomatically. After ten days her serum level of phenobarbital still had not decreased and she was not clinically recovered. The patient was transferred to another hospital for hemoperfusion to decrease the level of phenobarbital. After hemoperfusion the level of phenobarbital dropped significantly and the patient recovered neurologically. Phenobarbital has a long elimination half-life and for this reason it is advisable to use means to accelerate clearance until the clinical condition of the patient shows improvement. Multiple-dose activated charcoal effects the elimination of phenobarbital. If elimination needs to be speeded up, then hemoperfusion can be considered. If this technique is unavailable, hemodialysis is a good alternative.
一名44岁女性在自杀未遂后被发现昏迷。毒理学筛查显示苯巴比妥中毒。对该患者进行了对症治疗。十天后,她的苯巴比妥血清水平仍未下降,且临床症状未恢复。该患者被转至另一家医院进行血液灌流以降低苯巴比妥水平。血液灌流后,苯巴比妥水平显著下降,患者神经功能恢复。苯巴比妥的消除半衰期很长,因此建议采用加速清除的方法,直到患者的临床状况有所改善。多次剂量活性炭可促进苯巴比妥的消除。如果需要加快清除速度,可考虑血液灌流。若无法采用该技术,血液透析是一个不错的选择。