最后审阅: 18 九月 2021
最后更新: 17 七月 2020

小结

定义

病史和体格检查

其他诊断因素

  • 恶心和呕吐
  • 危险因素
  • 右上象限腹痛
  • 黄疸
  • 肝肿大
  • 意识水平改变
  • 扑翼样震颤
  • 会阴疼痛

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

诊断性检查

首要检查

  • 血清中对乙酰氨基酚浓度
  • 肝功能检测
  • 凝血酶原时间和 INR
  • 血糖
  • 尿素、肌酐及电解质
  • 静脉或动脉血气检查
  • 全血细胞计数

需考虑的检查

  • 水杨酸水平
  • 尿液分析
  • 尿液药物筛查

治疗流程

撰稿人

专家顾问

Johann Grundlingh,

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

Honorary senior lecturer

Queen Mary University

London

UK

利益声明

JG declares that he has no competing interests.

Clarissa Ribeiro,

Senior Clinical Fellow

Newham University Hospital

Barts Health NHS Trust

London

UK

利益声明

CR declares that she has no competing interests.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:

Daniel K. Colby, MD

Assistant Professor

Department of Emergency Medicine

UC Davis Health

CA

Alastair Newton, MB ChB, FCEM

Consultant in Emergency Medicine

The Prince Charles Hospital

Brisbane

Australia

利益声明

DKC and AN declare that they have no competing interests.

同行评议者

Ruben Thanacoody,

Consultant Physician

Royal Victoria Infirmary

Newcastle upon Tyne Hospitals NHS Foundation Trust

Honorary Clinical Senior Lecturer in Clinical Pharmacology

Newcastle University

Honorary Consultant Clinical Toxicologist

Public Health England

Director

National Poisons Information Service (Newcastle unit)

Newcastle upon Tyne

UK

利益声明

RT was an investigator in the Scottish and Newcastle Antiemetic Pre-treatment for paracetamol poisoning (SNAP) study. RT declares that he has no other competing interests.

编辑

Annabel Sidwell,

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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