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从精神药物过量中恢复往往取决于从服药到就诊的时间、格拉斯哥昏迷量表,以及就诊时循环功能不全的体征。

Recovery from a psychotropic drug overdose tends to depend on the time from ingestion to arrival, the Glasgow Coma Scale, and a sign of circulatory insufficiency on arrival.

作者信息

Yanagawa Youichi, Sakamoto Toshihisa, Okada Yoshiaki

机构信息

Department of Traumatology and Critical Care Medicine, National Defense Medical College, 359-8513, Japan.

出版信息

Am J Emerg Med. 2007 Sep;25(7):757-61. doi: 10.1016/j.ajem.2006.12.006.

Abstract

PURPOSE

The aim of this study was to investigate which factors on arrival correlate with the duration of unconsciousness induced by a psychotropic drug overdose.

BASIC PROCEDURE

Patients were 175 consecutive intubated patients unconscious due to psychotropic drug overdose. They were divided into 2 groups, an "early" group in which the patients were extubated within 2 days from hospitalization, and a "delayed" group who were not extubated within 2 days.

MAIN FINDINGS

Glasgow Coma Scale (P = .001) scores in the early group were higher than those in the delayed group. The estimated time from ingestion to admission (P < .0001), creatine kinase level (P < .01), number of cases demonstrating shock (P < .05), shock index (P < .0001), and heart rate (P = .001) in the early group were smaller than those in the delayed group. Two subjects in the delayed group died of pneumonia and pulmonary embolism.

PRINCIPAL CONCLUSIONS

Delayed arrival from ingestion, a low level of unconsciousness, and a sign of circulatory insufficiency in a patient with a psychotropic drug overdose were risk factors of a delayed recovery and death.

摘要

目的

本研究旨在调查因精神药物过量导致昏迷的患者入院时的哪些因素与昏迷持续时间相关。

基本程序

研究对象为175例因精神药物过量而昏迷的连续插管患者。他们被分为两组,“早期”组患者在住院后2天内拔管,“延迟”组患者在2天内未拔管。

主要发现

“早期”组的格拉斯哥昏迷量表评分(P = .001)高于“延迟”组。“早期”组从服药到入院的估计时间(P < .0001)、肌酸激酶水平(P < .01)、出现休克的病例数(P < .05)、休克指数(P < .0001)和心率(P = .001)均低于“延迟”组。“延迟”组有2名患者死于肺炎和肺栓塞。

主要结论

精神药物过量患者服药后延迟入院、意识水平低和循环功能不全迹象是恢复延迟和死亡的危险因素。

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