Klein-Schwartz W, Oderda G M, Gorman R L, Favin F, Rose S R
Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore 21201.
Clin Pediatr (Phila). 1990 Jun;29(6):316-21. doi: 10.1177/000992289002900604.
A review of 339 treated acute iron ingestions was conducted to define treatment guidelines better. According to the poison center protocol, ingestions of 20-40 mg/kg of elemental iron required only home treatment, and ingestions of greater than or equal to 40 mg/kg required hospital referral. Gastrointestinal symptoms developed in 23% of patients. There were no seriously ill patients. No serious toxicity developed in patients ingesting 40-60 mg/kg. In 199 cases in which the dose ingested was known, the mean dose was 39.5 mg/kg. The peak measured serum iron levels ranged from 12 to 539 micrograms/dl. In 129 cases with serum iron levels reported, increasing serum iron levels were associated with vomiting (p = 0.006). Of 88 patients who received deferoxamine, 14 had urine color change. Urine color change was associated with symptoms (p = 0.005) but not with iron dose or peak serum iron level. The poison center protocol was changed to home management for ingestions of 20-60 mg/kg unless significant symptoms developed and hospital referral for ingestions greater than or equal to 60 mg/kg.
对339例急性铁摄入治疗病例进行了回顾，以更好地确定治疗指南。根据中毒控制中心的方案，摄入20 - 40毫克/千克元素铁的患者仅需在家治疗，而摄入大于或等于40毫克/千克的患者则需转诊至医院。23%的患者出现了胃肠道症状。没有重症患者。摄入40 - 60毫克/千克的患者未出现严重毒性反应。在已知摄入剂量的199例病例中，平均剂量为39.5毫克/千克。测得的血清铁水平峰值在12至539微克/分升之间。在报告了血清铁水平的129例病例中，血清铁水平升高与呕吐有关（p = 0.006）。在88例接受去铁胺治疗的患者中，14例出现尿液颜色改变。尿液颜色改变与症状有关（p = 0.005），但与铁剂量或血清铁水平峰值无关。中毒控制中心的方案改为：摄入20 - 60毫克/千克的患者，除非出现明显症状，否则在家处理；摄入大于或等于60毫克/千克的患者转诊至医院。
