Ross J P, Small T R, Lepage P A
Spartanburg Regional Medical Center, South Carolina, USA.
Am Surg. 1998 Mar;64(3):242-4.
Tricyclic antidepressants are a class of drugs commonly used for the treatment of depression. Tricyclic antidepressants account for approximately 20 to 25 per cent of drug overdoses that require acute medical admission. The most common cause of mortality is cardiovascular toxicity (e.g., arrhythmia, heart block, or hypotension). Other morbidities include conditions secondary to anticholinergic effects (central and peripheral) and respiratory complications. Ileus, constipation and urinary retention are common peripheral anticholinergic sequelae, whereas unusual complications include pancreatitis, intestinal pseudo-obstruction with cecal perforation, and sigmoid colon gangrene. We report a case of imipramine overdose that was complicated by toxic megacolon with an associated perforation.
三环类抗抑郁药是一类常用于治疗抑郁症的药物。在需要紧急住院治疗的药物过量案例中，三环类抗抑郁药约占20%至25%。最常见的死亡原因是心血管毒性（如心律失常、心脏传导阻滞或低血压）。其他发病情况包括继发于抗胆碱能作用（中枢和外周）的病症以及呼吸系统并发症。肠梗阻、便秘和尿潴留是常见的外周抗胆碱能后遗症，而不常见的并发症包括胰腺炎、伴有盲肠穿孔的肠道假性梗阻以及乙状结肠坏疽。我们报告一例因过量服用丙咪嗪并发中毒性巨结肠并伴有穿孔的病例。
