心脏骤停:一种罕见的巴克洛芬戒断并发症
Singh Karminder1, Arora Niraj1, Nattanmai Chandershekran Prem1
1Department of Neurocritical Care, University of Missouri Columbia School of Medicine, Columbia, MO, USA.
The Neurohospitalist
|August 29, 2025
概括
拔除巴克洛芬可能导致罕见但严重的戒断,包括心脏骤停. 这一案例证明了在没有重新插入巴克洛芬后成功控制无脉动电活动.
科学领域:
- 神经学
- 药理学
- 危急护理医学
背景情况:
- 巴克洛芬是一种GABA激动剂,通过管内 (IT) 治疗脊髓损伤患者的性,特别是严重的病例.
- 在IT移除后突然取消使用巴克洛芬可能会引起严重症状,包括发作,精神病和自主不稳定.
- 心脏骤停是巴克洛芬戒断的罕见但有记录的并发症,之前的病例涉及IT更换.
研究的目的:
- 报告一个罕见的无脉动电活动 (PEA) 停止后,巴克洛芬IT的移除.
- 突出成功的治疗巴克洛芬戒断引起的心脏骤停,而不需要IT的重新插入.
- 强调长期使用IT的患者应保持临床警.
主要方法:
- 一名33岁的脊髓损伤和的男性因伤口脱落而接受了巴克洛芬IT的切除.
- 摘取后24-48小时观察到心血管不稳定和变化,进展到PEA停止.
- 开始进行心肺复苏 (CPR),随后进行静脉镇静,并开始服用巴克洛芬和克洛纳泽.
主要成果:
- 患者经历了PEA停止,在三轮心肺复苏后恢复自发循环 (ROSC).
- 在10天内恢复了临床稳定性,使用了包括口服巴克洛芬在内的保守治疗,没有重新安装IT.
- 患者已成功从机械呼吸和镇静中解脱出来.
结论:
- 尽管心脏骤停很罕见,但在IT切除后,它可能是抗素戒断的并发症.
- 用口服药物进行保守的治疗可能有效地缓解严重的戒断症状,包括PEA停止.
- 医疗保健提供者应保持高的怀疑百洛芬戒断并发症的指数.
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