作者報告了肝膽胰外科中不常見的膽總管引流白膽汁14例和術后不尋常大出血2例，指出這些不常見表現(xiàn)實際上為肝功能不全的反映，當引起臨床醫(yī)師重視。同時還就肝功能不全的表現(xiàn)方式和治療進行了討論，強調保肝和營養(yǎng)支持治療是其根本治療措施。
【摘要】 目的 報道1例靜脈滴注胺碘酮致肝腎功能不全患者?！》椒ā?010年10月收治1例擴張性心肌病患者，治療過程中使用胺碘酮注射液，導致嚴重的肝腎功能不全。系統(tǒng)查閱中國期刊全文數(shù)據(jù)庫及外文數(shù)據(jù)庫Pubmed、Embase建庫至2011年8月關于胺碘酮致肝腎功能不全的相關文獻，進行靜脈胺碘酮致肝腎功能不全的可能性評估，探索胺碘酮靜脈滴注致肝功能不全的的作用機制。 結果 根據(jù)查閱文獻結果分析，此患者靜脈注射胺碘酮致肝功不全的可能性高，Naranjo概率評分分別為7分。 結論 提出臨床醫(yī)師和臨床藥師應進行胺碘酮靜脈的藥學監(jiān)護，高度的重視胺碘酮相關的不良反應，從而及時識別和防治胺碘酮所致肝腎功能不全，減少其不良預后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.