1例围手术期帕金森病撤药恶性综合征的病例分析  

Perioperative withdrawal malignant syndrome in Parkinson's disease:a case report

作　　者：孟慧杰 冀召帅 郭冬杰[2] Hui-Jie MENG;Zhao-Shuai JI;Dong-Jie GUO(Department of Pharmacy,Beijing Tsinghua Changgung Hospital/School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]清华大学附属北京清华长庚医院/清华大学临床医学院药学部,北京102218 [2]中日友好医院药学部,北京100029

出　　处：《药物流行病学杂志》2023年第8期941-944,共4页Chinese Journal of Pharmacoepidemiology

摘　　要：本文报道1例老年患者围手术期停用抗帕金森病药物引起的撤药恶性综合征,提示应提高医务人员对帕金森病撤药恶性综合征的重视,促进围手术期用药安全。患者因骨科手术停用多巴丝肼,术后出现发热、意识障碍、肌酸激酶升高和肌肉强直,症状出现后第2天恢复使用抗帕金森药物多巴丝肼,并加用美金刚,转入重症监护室治疗。药师对帕金森病撤药恶性综合征的治疗及预后情况进行文献复习,参与临床决策,监护患者治疗。患者恢复帕金森药物治疗后第2天体温下降至正常,第3天呼唤可睁眼,第11天神志清醒。患者术后发热不除外感染,予头孢哌酮舒巴坦治疗7 d后停抗感染治疗。经文献分析,帕金森病撤药恶性综合征在停药约1~4 d后出现症状,恢复用药约1~10 d后症状缓解。围手术期不能突然停用抗帕金森病药物,如需停药,建议术后及时恢复治疗,警惕撤药恶性综合征的发生。To improve the attention of medical staff to Parkinson's related withdrawal malignant syndrome and promote the safety of perioperative medication.The treatment process of malignant syndrome caused by perioperative withdrawal of anti Parkinson drugs in an elderly patient was analyzed retrospectively.The patient stopped taking levodopa/benserazide hydrochloride tablets because of orthopedic surgery.The patient developed fever,consciousness disorder,creatine kinase elevation and muscle rigidity after operation.On the second day after the onset of symptoms,the patient resumed levodopa/benserazide hydrochloride tablets,and memantine was added.At the same time,the patient was transferred to the intensive care unit.Pharmacists summarize the literature on the identification and prognosis of Parkinson's drug withdrawal malignant syndrome,provide monitoring and medication advice to the patients treatment.The patient's body temperature fell to normal on the second day after recovering Parkinson's drug treatment,he opened his eyes when called on the third day,and he was conscious on the eleventh day.As postoperative infection can not be excluded,cefoperazone sulbactam was administrated for 7 days.According to literature analysis,anti Parkinson's disease withdrawal syndrome symptoms occurred about 1-4 days after drug withdrawal,and symptoms relieved about 1-10 days after drug recovery.Anti-Parkinson drugs should not be stopped suddenly during perioperative period.If necessary,it is recommended to resume treatment in time after operation in case of drug withdrawal malignant syndrome.

关 键 词：帕金森病 撤药恶性综合征 多巴丝肼 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R969[医药卫生—临床医学]