大剂量氨氯地平中毒延治致多器官功能障碍1例  

Severe Amlodipine Toxicity:a Case Rescued with Plasma Exchange Combined with Blood Purification

作　　者：沈树超 雷晓兰 赵云燕 SHEN Shu-chao;LEI Xiao-lan;ZHAO Yun-yan(Intensive Care Unit,Guangzhou Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 510000,China;Intensive Care Unit,Guangzhou Medical University Affiliated Traditional Chinese Medicine Hospital,Guangzhou 510000,China)

机构地区：[1]广州中医药大学附属广州中医医院重症医学科 [2]广州医科大学附属中医医院重症医学科,广州510000

出　　处：《南昌大学学报（医学版）》2024年第4期103-106,F0003,共5页Journal of Nanchang University：Medical Sciences

基　　金：广东省自然科学基金面上项目(2022A1515011719)。

摘　　要：目的总结1例大剂量氨氯地平中毒患者的诊治经过。方法回顾患者的临床资料。方法回顾患者的临床资料。结果患者女,26岁,因超大剂量氨氯地平[口服216片(1080 mg)]中毒延治出现顽固性休克、肺水肿、心肾功能障碍,突出表现为早发的急性胃肠损伤及迟发的药物性胰腺炎,在常规内科治疗的同时实施血浆置换联合血液净化尽快地纠正顽固性休克和改善多器官功能障碍。患者成功获救。结论血浆置换联合血液净化是超大剂量氨氯地平中毒延治致多器官功能障碍的有效手段。Objective To report the case of a patient with multiple organ dysfunction caused by delayed treatment of high-dose amlodipine poisoning.Methods The diagnosis and treatment of a patient with high-dose amlodipine poisoning were retrospectively reviewed.Results A 26-year-old female,with a history of consumption of 216 tablets of 5 mg amlodipine(total 1080 mg),developed refractory shock,pulmonary edema,and cardiac and renal dysfunction due to extended treatment,highlighted by early-onset acute gastrointestinal injury and late-onset drug-induced pancreatitis.Along with conventional internal medicine treatment,plasma exchange combined with blood purification was implemented as soon as possible to correct intractable shock and improve multiple organ dysfunction.The patient was ultimately successfully rescued.Conclusions This report highlights a rare case of a massive amlodipine overdose(1080 mg)and plasma exchange combined with blood purification as a rescue therapy.

关 键 词：氨氯地平中毒 顽固性休克 多器官功能障碍 血浆置换联合血液净化 

分 类 号：R595.4[医药卫生—内科学]