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中毒、解毒、解毒剂——急性中毒的循证诊断与治疗。

Intox, detox, antidotes - Evidence based diagnosis and treatment of acute intoxications.

机构信息

GIZ-Nord Poisons Centre, University Medical Centre, Georg August University Göttingen, Robert Koch Str. 40, D-37075 Göttingen, Germany.

GIZ-Nord Poisons Centre, University Medical Centre, Georg August University Göttingen, Robert Koch Str. 40, D-37075 Göttingen, Germany.

出版信息

Eur J Intern Med. 2017 Nov;45:66-70. doi: 10.1016/j.ejim.2017.10.019. Epub 2017 Oct 31.

Abstract

BACKGROUND AND AIM

Aim of this review is to describe the role of clinical toxicology in the context of acute medicine. A special focus is put on antidotes and important aspects of diagnosis and therapy of acute intoxications. The data of the annual report of GIZ-Nord Poisons Centre is analyzed concerning the following aspects: what intoxications are relevant in acute medicine, are there special aspects in therapy, e.g. antidotes, and what antidotes are relevant? More over intoxication-related fatalities are analyzed.

RESULTS AND CONCLUSION

In 2015 the poisons centre was consulted in 33,000 cases of acute intoxications. The most important groups are drugs (e.g. antidepressants, beta blockers and calcium channel blockers), chemical products (e.g. products containing surfactant, corrosive substances and toxic alcohols like methanol), plants and recreational drugs. Intoxications are relevant in acute medicine. Some substances can cause fatal intoxications. Important antidotes are naloxone for opiods, acetylcystein for paracetamol, fomepizole and ethanol for toxic alcohols and diazepam for intoxications caused by chloroquine.

摘要

背景与目的

本综述旨在描述临床毒理学在急症医学中的作用。特别关注解毒剂以及急性中毒诊断和治疗的重要方面。分析 GIZ-Nord 毒物中心年度报告的数据,涉及以下方面:急性医学中哪些中毒是相关的,治疗中是否有特殊方面,例如解毒剂,哪些解毒剂是相关的?此外,还分析了与中毒相关的死亡情况。

结果与结论

2015 年,毒物中心共咨询了 33000 例急性中毒病例。最重要的群体是药物(如抗抑郁药、β受体阻滞剂和钙通道阻滞剂)、化学制品(如含有表面活性剂、腐蚀性物质和甲醇等有毒醇类的制品)、植物和娱乐性药物。中毒在急症医学中很常见。有些物质会导致致命的中毒。重要的解毒剂包括阿片类药物的纳洛酮、对乙酰氨基酚的乙酰半胱氨酸、甲醇和有毒醇类的甲福明和乙醇、氯喹中毒的地西泮。

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