Pond S M, Lewis-Driver D J, Williams G M, Green A C, Stevenson N W
Department of Medicine, Princess Alexandra Hospital, Brisbane, QLD.
Med J Aust. 1995 Oct 2;163(7):345-9. doi: 10.5694/j.1326-5377.1995.tb124625.x.
To test the hypothesis that administration of activated charcoal is as efficacious and safe as the combination regimen of gastric emptying plus charcoal in adults after acute oral overdose.
Prospective randomised controlled trial, with subjects presenting on odd-numbered dates allocated to the emptied group (E), and those on even-numbered dates to the not-emptied group (NE).
Princess Alexandra Hospital, Brisbane (a tertiary referral hospital), which serves an adult urban community, between 4 January 1988 and 11 June 1990.
Consecutive patients (13 years or older) who presented to the Emergency Department after ingesting an overdose of one or more compounds able to be adsorbed by activated charcoal.
All patients received charcoal by the oral or nasogastric route. Those in the E group also had gastric emptying by ipecac-induced emesis or gastric lavage.
Clinical course during the first six hours after treatment began, length of hospital stay, complications.
876 patients were eligible for the study. There were no significant differences between the E and NE groups in age and sex distribution, severity of the overdose or other characteristics, except the mean interval between presentation and administration of charcoal (91 min [SD, 52] for E group and 55 [SD, 41] for NE group; P = 0.0001). There were no significant differences between the E and NE groups in outcome, even when the groups were stratified for severity of the overdose or into subgroups that presented sooner or later than one hour after ingestion.
Gastric emptying can be omitted from the treatment protocol for adults after acute oral overdose.
验证以下假设：对于急性口服过量的成人，给予活性炭治疗与胃排空加活性炭联合治疗方案同样有效且安全。
前瞻性随机对照试验，将奇数日期就诊的受试者分配至排空组（E组），偶数日期就诊的受试者分配至未排空组（NE组）。
布里斯班亚历山德拉公主医院（一家三级转诊医院），服务于城市成年社区，时间为1988年1月4日至1990年6月11日。
连续纳入的患者（年龄13岁及以上），这些患者在摄入一种或多种可被活性炭吸附的化合物过量后就诊于急诊科。
所有患者通过口服或鼻胃管途径接受活性炭治疗。E组患者还通过吐根糖浆催吐或洗胃进行胃排空。
治疗开始后前6小时的临床过程、住院时间、并发症。
876例患者符合研究条件。E组和NE组在年龄、性别分布、过量严重程度或其他特征方面无显著差异，但活性炭给药与就诊的平均间隔时间除外（E组为91分钟[标准差，52]，NE组为55分钟[标准差，41]；P = 0.0001）。E组和NE组在结局方面无显著差异，即使根据过量严重程度分层或分为摄入后1小时内或之后就诊的亚组。
对于急性口服过量的成人，治疗方案中可省略胃排空措施。
