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卡马西平中毒后癫痫患者的危险因素及治疗结果:一项为期两年的横断面研究。

Risk factors and the outcome of therapy in patients with seizure after Carbamazepine poisoning: A two-year cross-sectional study.

作者信息

Yaraghi Ahmad, Eizadi-Mood Nastaran, Salehi Marzieh, Massoumi Gholamreza, Zunic Lejla, Sabzghabaee Ali Mohammad

机构信息

Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Pharm Pract. 2015 Jan-Mar;4(1):18-23. doi: 10.4103/2279-042X.150046.

Abstract

OBJECTIVE

We aimed to investigate the frequency of seizure after acute carbamazepine poisoning and the important risk factors related to the outcomes of therapy.

METHODS

In this two-year cross-sectional study conducted in a University Hospital in Iran, 114 patients with acute carbamazepine poisoning were divided into two groups of with seizure (n = 8) and without seizure (n = 106) after intoxication. Demographic data, average amount of drug ingestion, time elapsed from ingestion to hospital admission, history of seizure before poisoning, mental status, visual disturbances and nystagmus, duration of hospitalization, the outcomes of therapy, arterial blood gas values and serum biochemical indices were compared between the two groups.

FINDINGS

Patients with seizure had an estimated (Mean ± SD) ingestion of 14,300 ± 570 mg carbamazepine, which was significantly higher (P < 0.0001) than the seizure-free group (4600 ± 420 mg). The estimated average time between drug ingestion and hospital admission in patients with seizure and the seizure-free group were 515 ± 275 and 370 ± 46 minutes, respectively (P < 0.0001). In this study, 104 out of the total number of patients had recovered without any complication. Need for respiratory support, including airway support or intubation were the most recorded complication. One patient died after status epilepticus and aspiration pneumonia.

CONCLUSION

The ingested amount of carbamazepine and the time elapsed from the ingestion of drug to hospital admission may influence the occurrence of seizure after acute carbamazepine poisoning; however, the outcome of supportive care in these patients seems to be positive.

摘要

目的

我们旨在调查急性卡马西平中毒后癫痫发作的频率以及与治疗结果相关的重要危险因素。

方法

在伊朗一家大学医院进行的这项为期两年的横断面研究中,114例急性卡马西平中毒患者在中毒后被分为有癫痫发作组(n = 8)和无癫痫发作组(n = 106)。比较两组患者的人口统计学数据、药物摄入平均量、从摄入到入院的时间、中毒前癫痫发作史、精神状态、视觉障碍和眼球震颤、住院时间、治疗结果、动脉血气值和血清生化指标。

结果

有癫痫发作的患者卡马西平估计摄入量(均值±标准差)为14300±570毫克,显著高于无癫痫发作组(4600±420毫克)(P < 0.0001)。有癫痫发作组和无癫痫发作组患者从药物摄入到入院的估计平均时间分别为515±275分钟和370±46分钟(P < 0.0001)。在本研究中,104例患者全部康复且无任何并发症。需要呼吸支持,包括气道支持或插管是记录最多的并发症。1例患者在癫痫持续状态和吸入性肺炎后死亡。

结论

卡马西平的摄入量以及从药物摄入到入院的时间可能会影响急性卡马西平中毒后癫痫发作的发生;然而,这些患者的支持性治疗结果似乎是积极的。

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