富马酸喹硫平中毒合并横纹肌溶解与锥体外系不良反应1例

A Case of Quetiapine Fumarate Intoxication with Rhabdomyolysis and Extrapyramidal Adverse Symptoms

摘要: 本文就1例大剂量富马酸喹硫平中毒患者成功救治进行回顾分析。患者口服富马酸喹硫平片60片(6 g) 12.5小时入院，予洗胃、血浆吸附净化灌流清除血中喹硫平成分、补液。入院后出现横纹肌溶解、锥体外系反应、急性肾损伤等并发症。笔者认为：大剂量喹硫平中毒可出现多系统功能损伤、心律失常甚至MOF等严重后果。治疗目标为最大程度减轻喹硫平中毒对机体的损伤，加强药物代谢并排出。尽早启动血液净化是治疗成功的关键。首诊医生需尽早明确诊断并采取洗胃、补液、血液净化等关键救治措施，以期提高喹硫平中毒的抢救成功率和识别率。

Abstract: This article presents a retrospective analysis of the successful management of a case involving high-dose quetiapine fumarate intoxication. The patient was admitted 12.5 hours after ingesting 60 tablets of quetiapine fumarate (total 6 g). Treatment included gastric lavage, plasma adsorption hemoperfusion to remove quetiapine from the bloodstream, and intravenous fluid resuscitation. Following admission, the patient developed complications including rhabdomyolysis, extrapyramidal symptoms, and acute kidney injury (AKI). The authors propose that high-dose quetiapine intoxication may lead to multi-organ dysfunction, cardiac arrhythmias, and even multiple organ failure (MOF). Therapeutic objectives focus on minimizing systemic toxicity induced by quetiapine intoxication through enhanced drug clearance and accelerated elimination. Early initiation of blood purification (e.g., hemoperfusion) is pivotal for successful management. First-line physicians must prioritize rapid diagnosis and implement critical interventions, including gastric lavage, fluid resuscitation, and extracorporeal detoxification to improve survival rates and enhance early recognition of quetiapine poisoning.