严重丙戊酸盐诱导的高氨血症性脑病通过腹膜透析成功治疗。
Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis.
作者信息
Kumar Amandeep, Suri Ashish, Sharma Bhawani S
机构信息
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Indian J Crit Care Med. 2014 Jul;18(7):461-3. doi: 10.4103/0972-5229.136076.
Valproic acid (VPA) is a commonly used drug for epilepsy, psychiatric disorders and migraine and is frequently used in neurosurgical intensive care units. Though most of its side-effects are mild and transient, certain idiosyncratic side-effects have been attributed to VPA. Valproate induced hyperammonemia (VIH) is one such side-effect. VIH can produce symptoms of encephalopathy known as valproate induced hyperammonemic encephalopathy (VHE). VIH and VHE usually respond to withdrawal of VPA. However, in some cases VHE can be unresponsive to supportive measures and severe enough to be life-threatening. In such cases, dialysis can be used to rapidly reverse hyperammonemia and VHE and can prove to be a lifesaving measure. We report such a case of VIH and life-threatening VHE in a postoperative neurosurgical patient that was managed successfully with peritoneal dialysis.
丙戊酸（VPA）是一种常用于治疗癫痫、精神疾病和偏头痛的药物，在神经外科重症监护病房中也经常使用。虽然其大多数副作用轻微且短暂，但某些特异质性副作用已被归因于VPA。丙戊酸盐诱导的高氨血症（VIH）就是这样一种副作用。VIH可产生被称为丙戊酸盐诱导的高氨血症性脑病（VHE）的脑病症状。VIH和VHE通常在停用VPA后有所缓解。然而，在某些情况下，VHE可能对支持性措施无反应，严重到危及生命。在这种情况下，透析可用于迅速逆转高氨血症和VHE，并可证明是一种挽救生命的措施。我们报告了一例术后神经外科患者发生VIH和危及生命的VHE的病例，该病例通过腹膜透析成功得到治疗。
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