【摘要】 概述:与电抽搐治疗相关的猝死极其罕见。本文报告中一例58岁男性患者在本疗程首次改良电抽搐治疗(modified electroconvulsive therapy,MECT)后1小时内死于心脏骤停。该患者有双相障碍病史20年,既往无心脏疾病病史或指征,本次实施MECT为治疗不伴精神病性症状的复发性躁狂发作。本次MECT并未产生惊厥。治疗结束后病人立即恢复意识、生命体征稳定,但被推入观察室后迅速恶化。我们未能进行尸检,但推测最可能的原因是MECT前17小时使用了氟哌啶醇,加剧了无抽搐MECT对心脏的影响。该案例强调对准备用MECT的患者进行全面的心脏检查是必须的(对老年人也许还要检测心肌酶谱),并且需慎重考虑同时使用抗精神病药物和MECT。更多还原

【Abstract】 Sudden deaths associated with the use of electroconvulsive therapy are rare. In this case repor a 58-year-old male with a 20-year history of bipolar disorder and no history or signs of cardiac illness die from cardiac arrest within one hour of receiving an initial session of modified electroconvulsive therap(MECT) to treat a recurrent episode of non-psychotic mania. The patient regained consciousness and wa medically stable immediately after the MECT session(which did not produce a convulsion) but deteriorate rapidly after transfer to the recovery room. It was not possible to conduct an autopsy, but the author surmise that the most probable cause was that the use of haloperidol 17 hours prior to MECT exacerbate the cardiac effects of nonconvulsive MECT. The case highlights the need for a thorough cardiac work-up o patients being considered for MECT(possibly including assessment of cardiac enzymes in older individuals and careful consideration of the concurrent use of antipsychotic medications and MECT.更多还原