Serjeant L, Evans J, Sampaziotis F, Petchey W G
Department of Nephrology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Department of Hepatology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
BMJ Case Rep. 2017 Jan 17;2017:bcr2016218667. doi: 10.1136/bcr-2016-218667.
A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines.
一名23岁女性因出现危及生命的对乙酰氨基酚过量的临床和生化特征而就诊较晚。尽管启动了N-乙酰半胱氨酸治疗，但由于存在线粒体功能障碍的证据以及对乙酰氨基酚水平极高，决定对患者进行紧急透析以清除母体药物。这一措施非常有效，在持续的支持治疗下，患者完全康复，无需进行移植。该病例突出了体外治疗在某些对乙酰氨基酚过量病例中作为一种治疗选择的作用，这与国际指南一致。
