Kornberg A E, Dolgin J
Division of Emergency Medicine, Children's Hospital of Buffalo, New York 14222.
Ann Emerg Med. 1991 Jun;20(6):648-51. doi: 10.1016/s0196-0644(05)82385-6.
To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time.
During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial.
All patients were recruited and studied in a pediatric emergency department.
Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral ingestions.
Group 1 received SOI before AC. Group 2 received only AC.
Group 1 patients took significantly longer to receive AC than group 2 from the time of ED arrival (2.6 +/- 0.1 vs 0.9 +/- 0.1 hours, P less than .0001). Group 1 children were significantly more likely to vomit AC than were group 2 children (18 of 32 vs six of 38, P less than .001). Patients receiving SOI who were subsequently discharged spent significantly more time in the ED than those receiving only AC (4.1 +/- 0.2 vs 3.4 +/- 0.2 hours, P less than .05).
Ipecac delays the administration of AC, hinders its retention, and prolongs ED time in pediatric ingestion patients. These data support the recommendation that AC alone should be the gastrointestinal decontamination method of choice for the mild-to-moderate pediatric ingestion patient presenting to an ED.
确定吐根糖浆（SOI）对接受活性炭（AC）的时间、活性炭的保留情况以及急诊总时长的影响。
在两年期间，患者被纳入一项前瞻性、随机、非盲、对照试验。
所有患者均在儿科急诊科招募和研究。
70名6岁以下儿童（平均年龄2.4±0.2岁），表现为轻至中度急性经口摄入。
第1组在服用活性炭之前接受吐根糖浆。第2组仅接受活性炭。
从抵达急诊科之时起，第1组患者接受活性炭的时间显著长于第2组（2.6±0.1小时对0.9±0.1小时，P<0.0001）。第1组儿童吐出活性炭的可能性显著高于第2组儿童（32例中有18例对38例中有6例，P<0.001）。随后出院的接受吐根糖浆治疗的患者在急诊科停留的时间显著长于仅接受活性炭治疗的患者（4.1±0.2小时对3.4±0.2小时，P<0.05）。
吐根糖浆会延迟活性炭的给药，阻碍其保留，并延长儿科摄入患者的急诊时间。这些数据支持以下建议，即对于前往急诊科的轻至中度儿科摄入患者，仅使用活性炭应作为胃肠道去污的首选方法。
