抗精神病药物致恶性综合征1例并文献复习

A Case of Neuroleptic Malignant Syndrome Caused by Antipsychotic Drugs and Literature Review

关键词:  恶性综合征  抗精神病药物

Key words:  neuroleptic malignant syndrome  antipsychotic drugs

摘要:

目的 探讨抗精神病药物致恶性综合征的临床特征，以提高对综合征的认识，降低误诊率及病死率。方法 回顾性分析1例抗精神病药物致恶性综合征患者的临床资料并检索、复习相关文献。结果 该例患者长期服用氯丙嗪、碳酸锂、氯氮平等抗精神病药物，疗效不佳，入院时肌注氟哌啶醇、加服阿立哌唑5 d后出现高热、意识障碍、四肢肌张力高、进食困难及自主神经功能紊乱，排除性诊断后予以综合治疗有效，患者病情逐渐好转。结论 恶性综合征是抗精神病药物所致严重不良反应，在临床上较为罕见，病死率可高达20%~30%，尽早诊断及早期治疗同时，应注意防治横纹肌溶解症等并发症。

Abstract:

OBJECTIVE To explore the clinical features of neuroleptic malignant syndrome caused by antipsychotic drugs, in order to improve the understanding of the syndrome and reduce the misdiagnosis rate and mortality rate. METHODS The clinical data of one patient with neuroleptic malignant syndrome induced by antipsychotic drugs was analyzed retrospectively, and the related literatures were reviewed. RESULTS The patient with long-term use of antipsychotic drugs chlorpromazine, lithium carbonate, clozapine, poor efficacy, admission intramuscular haloperidol, plus aripiprazole 5 d appear high fever, disturbance of consciousness, limb muscle tension high, eating difficulties and autonomic nerve function disorder, exclusive diagnosis after comprehensive treatment was effective, the patient gradually improved. CONCLUSION Neuroleptic malignant syndrome is a severe adverse reaction caused by antipsychotic drugs, is rare in clinic, mortality rate can be as high as 20%-30%, early diagnosis and early treatment and should be pay attention to the prevention and treatment of rhabdomyolysis and other complications.