毒物的强化清除
- Authors
- Michael J Burns, MD
Michael J Burns, MD
- Assistant Professor of Medicine
- Harvard Medical School
- Larissa I Velez, MD
Larissa I Velez, MD
- Professor of Emergency Medicine
- University of Texas Southwestern Medical Center
- Section Editors
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- Jonathan Grayzel, MD, FAAEM
Jonathan Grayzel, MD, FAAEM
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Assistant Professor of Emergency Medicine
- University of Massachusetts Medical School
- Translators
- 杜铁宽, 副主任医师，副教授
杜铁宽, 副主任医师，副教授
- 北京协和医院急诊科
引言
意外性和蓄意性的中毒和药物过量是发病、死亡和医疗保健支出的重要原因。在美国，估计每年有200-500万此类事件发生，但由于诊断不足和报告不充分，其真实的发病率未知[1-3]。
对中毒患者的处理从彻底评估、识别已发生的中毒、鉴别所涉及的物质、评定严重程度和预测毒性开始。治疗包括提供支持治疗、预防毒物吸收，以及在适当的情况下给予解毒药并进行毒物的强化清除。
本文将总结毒物摄入后加快毒物清除的方法。有关毒物摄入处理的一般问题，以及去污染和胃排空相关的特定问题将单独讨论。 (参见“成人药物中毒的一般处理方法”和“中毒患者的胃肠道去污染”和“Approach to the child with occult toxic exposure”)
强化清除技术可加速毒素的清除，但极少有研究评估这些技术是否真的缩短了临床毒性持续时间和/或改善了临床结局。强化毒素清除的主要方法如附表所示(表 1)。
强化清除技术的一般适应证包括：
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