采用延长血液透析和血浆置换治疗严重二甲双胍中毒。
Severe metformin intoxication treated with prolonged haemodialyses and plasma exchange.
作者信息
Turkcuer Ibrahim, Erdur Bulent, Sari Ismail, Yuksel Aykut, Tura Pinar, Yuksel Sinemis
机构信息
Department of Emergency Medicine, Pamukkale University, Denizli, Turkey.
出版信息
Eur J Emerg Med. 2009 Feb;16(1):11-3. doi: 10.1097/MEJ.0b013e32830a7567.
BACKGROUND
Biguanides pose a significant risk of morbidity, mortality and permanent sequelae secondary to prolonged periods of hypoglycaemia.
OBJECTIVES
To investigate the treatment of massive metformin overdose associated with lactic acidosis.
CASE REPORT
We present the case of a 30-year-old woman, who attempted to commit suicide by ingesting an 85-g massive metformin overdose associated with severe lactic acidosis, which we treated by performing prolonged haemodialysis with bicarbonate and plasma exchange.
CONCLUSION
For the maximum elimination of metformin, extended haemodialysis is required and the treatment of the accompanying metabolic acidosis with bicarbonate is important for the effectiveness of the treatment. Patients benefit much more from the treatment of combined haemodialysis with plasma exchange.
背景
双胍类药物因长时间低血糖会带来显著的发病、死亡风险及永久性后遗症。
目的
探讨与乳酸酸中毒相关的大量二甲双胍过量服用的治疗方法。
病例报告
我们报告一例30岁女性病例，该患者摄入85克大量二甲双胍企图自杀，伴有严重乳酸酸中毒，我们通过进行长时间的碳酸氢盐血液透析和血浆置换对其进行治疗。
结论
为最大程度清除二甲双胍，需要延长血液透析时间，用碳酸氢盐治疗伴随的代谢性酸中毒对治疗效果很重要。联合血液透析与血浆置换治疗使患者获益更多。
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