Nfila G, Lee S, Binchy J
Ir Med J. 2014 Feb;107(2):47-8.
Paracetamol is involved in a large proportion of overdoses that present to the Emergency Department (ED), either as lone or mixed overdoses. Non-treatment of toxic levels can lead to fulminant liver failure. This study is to determine the impact the new UK treatment guidelines will have on patients presenting with paracetamol overdose. A retrospective review was performed on all patients who had paracetamol levels done in the ED between September 2011 and August 2012. A total of 523 patients were identified, 95 (18%) of whom had detectable paracetamol levels. 74 patients from the 95 were evaluated. 18 (24%) patients were treated with N-acetylcysteine as per the then paracetamol overdose guidelines. Using the new guidelines would have resulted in 3 more patients being admitted. Our study shows that most patients who present following paracetamol overdose do not require treatment with N-acetylcysteine and suggests that the introduction of the new UK treatment guidelines is likely to result in only a small increase in the number of patients requiring treatment.
对乙酰氨基酚导致了大量进入急诊科（ED）的过量用药情况，这些过量用药既可能是单独用药过量，也可能是混合用药过量。对中毒水平不进行治疗会导致暴发性肝衰竭。本研究旨在确定英国新的治疗指南对出现对乙酰氨基酚过量用药的患者会产生何种影响。对2011年9月至2012年8月期间在急诊科进行对乙酰氨基酚水平检测的所有患者进行了回顾性研究。共识别出523名患者，其中95名（18%）患者的对乙酰氨基酚水平可检测到。对这95名患者中的74名进行了评估。按照当时的对乙酰氨基酚过量用药指南，18名（24%）患者接受了N-乙酰半胱氨酸治疗。采用新指南会导致多3名患者入院。我们的研究表明，大多数出现对乙酰氨基酚过量用药的患者不需要接受N-乙酰半胱氨酸治疗，并且表明英国新治疗指南的引入可能只会使需要治疗的患者数量略有增加。
