Jakobson A M, Kreuger A, Mortimer O, Henningsson S, Seidel H, Moe P J
Department of Paediatrics, Akademiska sjukhuset, Uppsala, Sweden.
Acta Paediatr. 1992 Apr;81(4):359-61. doi: 10.1111/j.1651-2227.1992.tb12244.x.
Two patients aged 11 and four years, were accidentally given a 10-fold overdose of intrathecal methotrexate while being treated for malignant disease. Neither patient developed any signs of neurotoxicity and exchange of lumbar cerebro-spinal fluid was started 3 and 5 h later, respectively. In one of the patients, who received 120 mg of methotrexate intrathecally, 31% of the given dose was recovered during 2 h of cerebrospinal fluid exchange that was started 3 h after the accidental overdosage. No sequelae were observed in any of the patients. Cerebrospinal fluid exchange is safe and can be recommended in all cases of intrathecal methotrexate overdosage. Ventriculo-cisternal perfusion is not necessary in cases of a 10-fold overdose if the patient has no signs of acute neurotoxicity.
两名年龄分别为11岁和4岁的患者在接受恶性疾病治疗时，意外鞘内注射了10倍过量的甲氨蝶呤。两名患者均未出现任何神经毒性迹象，分别在3小时和5小时后开始进行腰椎脑脊液置换。其中一名鞘内注射了120毫克甲氨蝶呤的患者，在意外过量用药3小时后开始的2小时脑脊液置换过程中，回收了31%的给药剂量。所有患者均未观察到后遗症。脑脊液置换是安全的，在所有鞘内注射甲氨蝶呤过量的病例中均可推荐使用。如果患者没有急性神经毒性迹象，在10倍过量的情况下无需进行脑室-脑池灌注。
