抗胆碱能副作用继发膀胱持续扩张导致的肺栓塞。
Pulmonary embolism from persistent dilatation of the bladder secondary to anticholinergic side effects.
作者信息
Ito Masanobu, Hatta Kotaro, Miyakawa Koichi, Arai Heii
机构信息
Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan.
出版信息
Gen Hosp Psychiatry. 2009 Mar-Apr;31(2):187-9. doi: 10.1016/j.genhosppsych.2008.07.010. Epub 2008 Sep 2.
OBJECTIVE
To discuss the risk that bladder distention resulting from anticholinergic side effects of antipsychotics can cause iliac vein compression syndrome (IVCS) and subsequent pulmonary embolism (PE).
METHOD
Case report, review of the literature and discussion.
RESULTS
We report the case of a 65-year-old man with depression who experienced PE associated with IVCS due to a distended urinary bladder resulting from anticholinergic side effects. PE disappeared after conservative therapy with heparin followed by warfarin.
CONCLUSION
When drugs with anticholinergic effects are given to immobilized patients such as those with severe depression, close observation including monitoring of urine volume is needed to prevent IVCS caused by drug-induced urinary retention, and subsequent PE.
目的
探讨抗精神病药物的抗胆碱能副作用导致膀胱扩张进而引起髂静脉压迫综合征（IVCS）及随后发生肺栓塞（PE）的风险。
方法
病例报告、文献回顾及讨论。
结果
我们报告了一例65岁抑郁症男性患者，其因抗胆碱能副作用导致膀胱扩张而发生与IVCS相关的PE。经肝素继以华法林的保守治疗后，PE消失。
结论
当给诸如重症抑郁症患者等制动患者使用具有抗胆碱能作用的药物时，需要密切观察，包括监测尿量，以预防药物性尿潴留所致的IVCS及随后的PE。
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