Underhill T J, Greene M K, Dove A F
Accident and Emergency Department, University Hospital Nottingham, U.K.
Arch Emerg Med. 1990 Sep;7(3):148-54. doi: 10.1136/emj.7.3.148.
The aim of this prospective trial was to compare the efficacy of gastric lavage, activated charcoal and ipecacuanha at limiting the absorption of paracetamol in overdose and to assess the significance of the continued absorption of paracetamol following treatment. Patients aged 16 and over who had ingested 5 gms or more of paracetamol within 4h of admission were entered into the trial. The percentage fall in plasma paracetamol level was used as the measure of the success of a treatment at limiting absorption. The mean percentage fall was 39.3 for gastric lavage, 52.2 for activated charcoal and 40.7 for ipecacuanha, with a significant difference between the treatment methods (p = 0.03). Activated charcoal was more effective at limiting the absorption of paracetamol following overdose than either gastric lavage or ipecacuanha induced emesis. In treated patients continuing paracetamol absorption is not significant if more than 2h have elapsed since ingestion.
这项前瞻性试验的目的是比较洗胃、活性炭和吐根在过量服用对乙酰氨基酚时限制其吸收的疗效，并评估治疗后对乙酰氨基酚持续吸收的意义。纳入试验的患者为16岁及以上，入院后4小时内摄入5克或更多对乙酰氨基酚的患者。血浆对乙酰氨基酚水平的下降百分比被用作衡量治疗限制吸收成功与否的指标。洗胃的平均下降百分比为39.3%，活性炭为52.2%，吐根为40.7%，治疗方法之间存在显著差异（p = 0.03）。活性炭在过量服用后限制对乙酰氨基酚吸收方面比洗胃或吐根诱导呕吐更有效。在接受治疗的患者中，如果自摄入后已过去超过2小时，对乙酰氨基酚的持续吸收并不显著。
