BMJ Best Practice
最后审核时间： 六月 2019
最近更新时间： 三月 2019

小结

定义

病史和查体

关键诊断因素

  • 自我伤害未遂
  • 为缓解疼痛反复应用非处方止痛药
  • 无症状就诊
  • 恶心、呕吐或腹痛
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危险因素

  • 自我伤害史
  • 为缓解疼痛而频繁或重复服药的病史
  • 谷胱甘肽缺乏
  • 肝药酶诱导剂（CYP 450 诱导剂）
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诊断性检查

首要检查

  • 血清对乙酰氨基酚水平
  • 血清 AST 和 ALT 水平
  • 动脉血 pH 值和乳酸水平
  • 尿素和电解质或肾功能检查
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需要考虑的检查

  • 血清水杨酸水平
  • 尿液药物筛查
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治疗流程

急性

急性单次摄入

累积摄入对乙酰氨基酚

反复摄入超治疗剂量的对乙酰氨基酚：伴有肝中毒体征

反复摄入超治疗剂量的对乙酰氨基酚：无肝脏中毒体征

贡献者

作者 查看所有

Associate Professor of Emergency Medicine

University of Colorado School of Medicine

Aurora

CO

利益冲突披露
The employer of KH received research grants from McNeil Consumer Healthcare, a manufacturer of acetaminophen.

Consultant in Emergency Medicine

Emergency Department

The Prince Charles Hospital

Brisbane

Queensland

Australia

利益冲突披露
AN declares that he has no competing interests.

Professor Kennon Heard and Dr Alastair Newton would like to gratefully acknowledge Professor Allan R. Mottram, a previous contributor to this topic.

利益冲突披露
ARM declares that he has no competing interests.

同行评议专家 查看所有

Clinical Faculty

Department of Toxicology

Rocky Mountain Poison & Drug Center

Denver

CO

利益冲突披露
SP declares that he has no competing interests.

Director

Division of Research

Department of Emergency Medicine

Albert Einstein Medical Center

Philadelphia

PA

利益冲突披露
GFOM declares that he has no competing interests.

Associate Professor

Department of Medicine

McGill University

Emergency Physician and Medical Toxicologist

McGill University Health Centre

Medical Toxicologist

Centre Antipoison du Québec

Montreal

Quebec

Canada

利益冲突披露
SG declares that she is an unpaid co-investigator in the Canadian Acetaminophen Overdose Study and unpaid co-chair of the Extracorporeal Treatment In Poisoning workgroup.

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