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題 名 | 抗精神病藥物惡性症候群及其治療=Neuroleptic Malignant Syndrome and Treatment |
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作 者 | 黃三原; 林為文; 諶立中; 沈君傑; 陸汝斌; | 書刊名 | 醫學研究 |
卷 期 | 19:6 1999.05[民88.05] |
頁 次 | 頁323-336 |
分類號 | 415.96 |
關鍵詞 | 抗精神病藥物惡性症候群; 高溫發燒; 肌肉僵硬; 意識障礙; 自律神經失調; Neuroleptic malignant syndrome; Hyperthermia; Muscle rigidity; Autonomic disturbances; Fluctuation of consciousness; |
語 文 | 中文(Chinese) |
中文摘要 | 抗精神病藥物惡性症候群[Neuroleptic malignant syndrome(NMS)]是服用抗精神病藥物(neuroleptic)後所引起一種罕見、但致命性之症候群,而其臨床症狀主要包括高溫發燒,肌肉僵硬,意識障礙,自律神經失調(autonomic disturbances)。NMS發生率約1-2%,死亡率則高達15-22%。而除抗精神病藥物外,其他情況如突然中斷或任意減少服用抗巴金森氏症藥物及服用非抗精神病之多巴胺抑制劑(如metoclopramide),甚至中樞神經系統感染皆會產生類似抗精神病藥物惡性症候群,故此症候群不僅是臨床精神科醫師需應注意,亦是其他科醫師不容忽視的一項重大急症。 本文針對NMS之流行病學,病理生理機轉,臨床特徵,臨床病程,預後,診斷標準,鑑別診斷方針及治療策略做一嚴謹綜合性文獻回顧,並對其常見內科合併症作一分析,期望能提供臨床醫師及醫療相關人員對此症侯群有一完整認識,並能對此症侯群做早期預防、迅速且正確的診斷及治療。 |
英文摘要 | The neuroleptic malignant syndrome (NMS) occurring during treatment with neuroleptics is a rare but life-threatening syndrome. The main clinical manifestations of NMS include high fever, muscle rigidity, fluctuation of consciousness, and autonomic disturbances. The incidence of NMS is about 1-2% and the mortality rate is as high as 15-22%. Besides neuroleptics, there are serval conditions causing NMS-like syndrome, including sudden withdrawal or decreasing dosage of dopaminergic medications for treating Parkinson's disease, non-neuroleptic dopamine antagonists (eg. metoclopramide), and central nervous system infection. Therefore, NMS is an emergent medical syndrome to which both psychiatrists and physicians should pay attention. In this article, authors review different aspects of NMS, including epidemiology, pathophysiology, clinical characteristics, clinical course and prognosis, diagnostic criteria, differential diagnoses, treatment strategies, and common medical complications. This review may provide physician and other clinical staff a holistic view and a guide in early prevention, rapid diagnosis and treatment of this syndrome. |
本系統中英文摘要資訊取自各篇刊載內容。