Hassig S R, Linscheer W G, Murthy U K, Miller C, Banerjee A, Levine L, Wagner K, Oates R P
Section of Gastroenterology, Veterans Administration Medical Center, Syracuse, New York 13210.
Dig Dis Sci. 1993 Aug;38(8):1395-401. doi: 10.1007/BF01308594.
The purpose of this study was to evaluate whole gut lavage with polyethylene glycol electrolyte solution (Colyte), as a potentially adjunctive measure in lowering serum acetaminophen levels. The effect of bowel lavage was evaluated on serial serum acetaminophen concentrations after 2-g and 4-g doses in 7 and 12 male patients, respectively. Mean peak level of serum acetaminophen after 2 g (60 min after intake) was not significantly lowered by bowel lavage. After 4 g, peak acetaminophen serum levels were significantly lower after bowel lavage (65.4% of controls, P < 0.001). Urinary concentrations of the mercapturic acid conjugate of the toxic metabolite were also significantly reduced by lavage (55% after 2 g and 45% after 4 g, P < 0.01). Activated charcoal given orally after administration of 4 g of acetaminophen had no significant effect on peak serum levels and had no additive effect on lavage. These studies suggest that rapid, complete bowel lavage with a polyethylene glycol electrolyte solution may be beneficial as an adjunct to the treatment of the acetaminophen intoxication.
本研究的目的是评估用聚乙二醇电解质溶液（Colyte）进行全肠道灌洗作为降低血清对乙酰氨基酚水平的一种潜在辅助措施的效果。分别对7例和12例男性患者给予2克和4克剂量的对乙酰氨基酚后，评估肠道灌洗对血清对乙酰氨基酚系列浓度的影响。给予2克对乙酰氨基酚后（摄入后60分钟）血清对乙酰氨基酚的平均峰值水平未因肠道灌洗而显著降低。给予4克后，肠道灌洗后对乙酰氨基酚血清峰值水平显著降低（为对照组的65.4%，P<0.001）。灌洗还使有毒代谢物的巯基尿酸结合物的尿液浓度显著降低（2克后降低55%，4克后降低45%，P<0.01）。给予4克对乙酰氨基酚后口服活性炭对血清峰值水平无显著影响，对灌洗也无附加作用。这些研究表明，用聚乙二醇电解质溶液进行快速、彻底的肠道灌洗作为对乙酰氨基酚中毒治疗的辅助措施可能有益。
