Eze E, Workman M, Donley B
Mental Health Unit of Three Rivers Medical Center, Louisa, Kentucky 41230, USA.
Psychiatr Serv. 1998 Oct;49(10):1358-9. doi: 10.1176/ps.49.10.1358.
The authors report the case of a patient who developed hyperammonemia and coma during therapy with valproic acid for affective disorder. Onset of the coma was gradual and initially interpreted as a therapeutic reduction in the patient's anxiety. In a psychiatric setting, treatment of hyperammonemia may be delayed if a patient's increasing lethargy is interpreted as a therapeutic response. Staff may need to be educated about the potential for hyperammonemia, and patients whose tolerance for valproic acid is unknown may need to be monitored for liver function and blood levels of urea and ammonia.
作者报告了一例情感障碍患者在使用丙戊酸治疗期间发生高氨血症和昏迷的病例。昏迷起病渐进，最初被解释为患者焦虑情绪的治疗性减轻。在精神科环境中，如果将患者日益加重的嗜睡解释为治疗反应，高氨血症的治疗可能会延迟。可能需要对工作人员进行高氨血症可能性方面的教育，对于丙戊酸耐受性未知的患者，可能需要监测其肝功能以及尿素和氨的血药浓度。
