Albertson Timothy E, Owen Kelly P, Sutter Mark E, Chan Andrew L
Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA.
Int J Emerg Med. 2011 Oct 12;4:65. doi: 10.1186/1865-1380-4-65.
To define the role of gastrointestinal (GI) decontamination of the poisoned patient.
A computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.
Clinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.
The literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.
The current literature supports limited use of GI decontamination of the poisoned patient.
明确胃肠道净化在中毒患者治疗中的作用。
通过计算机检索PubMed/MEDLINE数据库中有关中毒患者胃肠道净化的文献，并对文献来源进行交叉引用。
对临床研究、动物研究和体外研究进行综述，以评估其与中毒患者胃肠道净化的临床相关性。
文献表明，以前广泛使用的积极治疗方法，包括使用吐根糖浆、洗胃和泻药，现在很少被推荐。对于缓释药物、金属以及吞食装有滥用药物的异物的患者，全肠灌洗仍经常被推荐，但支持该方法的高质量数据很少。活性炭（单剂量或多剂量）以前也是胃肠道净化的主要手段，但现在人们认识到活性炭的效用有限，且比以前认为的更依赖时间。这些建议促成了若干治疗指南，这些指南大多基于回顾性分析、动物研究或小病例系列，很少基于随机临床试验。
目前的文献支持对中毒患者有限度地使用胃肠道净化治疗。
