急诊毒理学检查在昏迷鉴别诊断中的价值
Value of emergency toxicological investigations in differential diagnosis of coma.
作者信息
Helliwell M, Hampel G, Sinclair E, Huggett A, Flanagan R J
出版信息
Br Med J. 1979 Oct 6;2(6194):819-21. doi: 10.1136/bmj.2.6194.819.
Abstract
Out of 208 cases of coma of unknown aetiology referred to the poisons unit of this hospital during 1978 for emergency toxicological investigations, 108 were found to be due to self-poisoning medical conditions, mainly neurological, accounted for coma in 90 patients; the cause was not ascertained in the remaining 10 cases. More than one preparation had been ingested by 58 (54%) of the poisoned patients, although barbiturates were the drugs most commonly encountered in the severe cases. Toxicological investigations should be considered in the differential diagnosis of coma when history, physical examination, and emergency biochemical measurements yield little diagnostic information.
摘要
1978年，208例病因不明的昏迷患者被送至本院中毒科进行紧急毒理学检查，其中108例被发现是由于自我中毒。90例患者的昏迷是由主要为神经方面的内科疾病所致；其余10例病因未明。58名（54%）中毒患者服用了不止一种制剂，不过巴比妥类药物是重症病例中最常出现的药物。当病史、体格检查及紧急生化检测几乎无法提供诊断信息时，在昏迷的鉴别诊断中应考虑进行毒理学检查。
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