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急性曲马多中毒及其临床和实验室检查结果。

Acute tramadol poisoning and its clinical and laboratory findings.

作者信息

Rahimi Hamid Reza, Soltaninejad Kambiz, Shadnia Shahin

机构信息

Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.

出版信息

J Res Med Sci. 2014 Sep;19(9):855-9.

Abstract

BACKGROUND

Tramadol is a centrally acting analgesic with opioid and nonopioid properties, which extensively used in the relief of mild to moderate pain. Tramadol poisoning is a common cause of acute pharmaceutical poisoning in Iran. There are a few studies about clinical and laboratory findings related to acute tramadol poisoning. Therefore, the aim of this study was to demonstrate the clinical and laboratory findings in tramadol acute poisoning cases.

MATERIALS AND METHODS

This was a retrospective descriptive study of patients with acute tramadol poisoning who referred to Loghman Hakim Hospital Poison Center during January to April 2012. Data such as patient's age, sex, time of ingestion, ingested dose, cause of poisoning, mean duration of hospitalization, patient's clinical presentations, laboratory findings, therapeutic measures, and patient's outcome have collected in a predesigned checklist.

RESULTS

A total of 144 patients including 111 men (77%) and 33 women (23%) with acute tramadol poisoning was included in this study. The mean ingested dose was 1971.2 mg (100-20000 mg). Seizure (47.91%) was the most frequent clinical symptom. Blood gas on admission showed pH (7.3 ± 0.1), PCO2 (49.7 ± 8.6 mmHg) and HCO3 (-) (24.1 ± 3.8 mEq/L), indicating pure acute respiratory acidosis may be occurred in tramadol-intoxicated patients. There were significant differences between tramadol-intoxicated cases with and without a seizure with regard to the time interval between ingestion and admission on hospital, ingested dose and PCO2.

CONCLUSION

Seizure and rise of PCO2 were the most findings in this study.

摘要

背景

曲马多是一种具有阿片类和非阿片类特性的中枢性镇痛药,广泛用于缓解轻至中度疼痛。曲马多中毒是伊朗急性药物中毒的常见原因。关于急性曲马多中毒的临床和实验室检查结果的研究较少。因此,本研究的目的是展示曲马多急性中毒病例的临床和实验室检查结果。

材料与方法

这是一项对2012年1月至4月转诊至洛格曼·哈基姆医院中毒中心的急性曲马多中毒患者的回顾性描述性研究。患者的年龄、性别、摄入时间、摄入剂量、中毒原因、平均住院时间、患者临床表现、实验室检查结果、治疗措施及患者结局等数据已收集在预先设计的检查表中。

结果

本研究共纳入144例急性曲马多中毒患者,其中男性111例(77%),女性33例(23%)。平均摄入剂量为1971.2毫克(100 - 20000毫克)。癫痫发作(47.91%)是最常见的临床症状。入院时血气分析显示pH值(7.3 ± 0.1)、二氧化碳分压(49.7 ± 8.6毫米汞柱)和碳酸氢根离子(24.1 ± 3.8毫当量/升),表明曲马多中毒患者可能发生单纯性急性呼吸性酸中毒。有癫痫发作和无癫痫发作的曲马多中毒病例在摄入至入院的时间间隔、摄入剂量和二氧化碳分压方面存在显著差异。

结论

癫痫发作和二氧化碳分压升高是本研究中最常见的检查结果。

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