Frappaz D, Bouffet E, Cochat P, Laville M, Finaz de Vilaine J, Philip T, Biron P, Zanettini M C, Latour J F, Gueho A
Service d'Oncologie pédiatrique, Centre Léon Bérard, Lyon.
Presse Med. 1988 Jun 11;17(23):1209-13.
Acute methotrexate intoxication occurred in 4 patients despite adequate alkaline hyperhydration and classical folinic acid rescue. Three of these patients had no previous risk factor. Charcoal haemoperfusion with haemodialysis was promptly instituted and the methotrexate blood levels rapidly decreased, avoiding further renal damage and multisystemic involvement. Chemotherapy could subsequently be performed in 3 of the 4 patients without delay and toxicity. Charcoal haemofiltration appears to be an excellent treatment of methotrexate intoxication.
尽管进行了充分的碱性水化和经典的亚叶酸救援，仍有4例患者发生了急性甲氨蝶呤中毒。其中3例患者既往无危险因素。立即进行了活性炭血液灌流联合血液透析，甲氨蝶呤血药浓度迅速下降，避免了进一步的肾损伤和多系统受累。4例患者中有3例随后能够及时且无毒性地进行化疗。活性炭血液滤过似乎是治疗甲氨蝶呤中毒的一种极佳方法。
