Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery_West China Medical Journal

Authors：

XUE Yang ¹ , LUO Shu ² , SUN Xiaokang ¹ , ZHAO Changming ¹ , GUO Xiangdong ¹

1. Department of Cardiothoracic Surgery; 2. Department of Internal Neurology; People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding?author：

Keywords：

食管癌; 酒精戒斷綜合征; 防治

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目的　探討食管癌術后酒精戒斷綜合征的原因及有效預防治療措施。方法　2000年1月－2011年10月共行食管癌手術935例，術后發生酒精戒斷綜合征16例，患者均為男性，年齡41～67歲，平均54歲。飲酒史16～47年，平均27.8年；每日飲白酒量為250～1 000 g，酒精含量162～590 g，平均321.5 g。所有患者均符合中國精神疾病分類與診斷標準第3版（CCMD-3）酒精戒斷綜合征診斷標準。在食管癌常規術后治療的基礎上，根據患者譫妄、煩躁、精神失常、昏迷等不同情況應用維生素B族、納絡酮、氟哌啶醇、氯丙嗪、安定、促進腦細胞代謝及補充能量等綜合治療，必要時予以鎮靜后氣管插管呼吸機輔助呼吸。結果　患者經治療后戒斷癥狀均完全消失，治療時間2～10 d，平均5.3 d。13例獲隨訪，隨訪時間4～18個月，均完全戒酒，其中1例術后8個月死于急性心肌梗死；余12例均恢復良好，且未出現酒精戒斷癥狀。結論　經合理有效的圍手術期處理，食管癌術后酒精戒斷綜合征發生率可明顯降低，詳細詢問病史，術前術后積極預防并及時給予有效的治療是治愈的關鍵。

Citation： XUE Yang,LUO Shu,SUN Xiaokang,ZHAO Changming,GUO Xiangdong. Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery. West China Medical Journal, 2012, 27(11): 1638-1640. doi: Copy

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13.	張會蓮. 警惕酒癮患者急性戒酒誘發酒精戒斷綜合征[J]. 臨床誤診誤治, 2010, 23(11): 1008-1009.
14.	汪建華, 龔云, 劉業, 等. 酒精戒斷性癲癇9例臨床分析[J]. 重慶醫學, 2012, 41(13): 1324-1325.
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16.	宋海東, 丁瑛, 沈鑒清, 等.曲唑酮與阿普唑侖治療酒精濫用后睡眠障礙的研究[J]．中國行為醫學科學, 2006, 15（5）：448.
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18.	Wasilewski D, Matsumoto H, Kur E, et al. Assessment of diazepam loading dose therapy of delirium tremens[J]. Alcohol Alcohol, 1996, 31(3): 273-278．.

1. 　林兆耆, 戴自英.實用內科學（下冊）[M].北京: 人民衛生出版社, 1986: 2133.
2. 　陳考珍, 顧柏林, 俞永寶.戒酒綜合征23例分析[J].卒中與神經疾病雜志, 2002, 19(2): 120.
3. 　Adinoff B. Double-blind study of alprazolam, diazepam, clonidine, and placebo in the alcohol withdrawal syndrome: preliminary findings[J]. Alcohol Clin Exp Res, 1994, 18(4): 873-878.
4. 　Banks WA, KastinAJ. Brain-to-blood transport of peptides and the alcohol withdrawal syndrome [J]. Ann N Y Acad Sci, 1994, 739: 108-118.
5. 　Sanna E, Talani G, Busonero F, et al. Brain steroidogenesis mediates ethanol modulation of GABAA receptor activity in rat hippocampus[J]. J Neurol Sci, 2004, 24(29): 6521-6530．.
6. 　Kumar S, Fleming RL, Morrow AL. Ethanol regulation of gaminobutyric acid A receptors：genomic and nongenomic mechanisms[J]. Pharmacol Ther, 2004, 101(3): 211-226．.
7. 　Hasegawa D, Matsuki N, Fujita M, et al. Kinetics of glutamate and aminobutyric acid in cerebrospinal fluid in acanine model of complex partial status epilepticus induced by kainic acid[J]. J Vet Med Sci, 2004, 66(12): 1555-1559．.
8. 　Loup F, Wiester HG, Yonekawa Y, et al. Selective alterations in GABAa receptor subtypes in human temporal lobe epilepsy[J]. J Neurol Sci, 2000, 20(14): 5401-5419．.
9. 　Blaesse P, Airaksinen MS, Rivera C, et al. Cation-chloride cotransporters and neuronal function[J]. Neuron, 2009, 61(6): 820-838．.
10. 　湯宜朗.酒中毒與戒酒綜合征的表現與治療[J].中國實用內科雜志, 1997, 17(11): 689-691.
11. 　陳彥方, 楊德森, 姚芳傳, 等.中國精神疾病分類與診斷標準（CCMD-3）[M].濟南: 山東科學技術出版社, 2001: 62-74.
12. 　Nordentoft M, Timm S, Hasselbalch E, et al. Thiamine pyrophosphate effect and erythrocyte transketolase activity during severe alcohol withdrawal syndrome[J]. Acta Psychiatr Scand, 1993, 88(2): 80-84.
13. 　張會蓮. 警惕酒癮患者急性戒酒誘發酒精戒斷綜合征[J]. 臨床誤診誤治, 2010, 23(11): 1008-1009.
14. 　汪建華, 龔云, 劉業, 等. 酒精戒斷性癲癇9例臨床分析[J]. 重慶醫學, 2012, 41(13): 1324-1325.
15. 　郭建一.住院停止飲酒誘發戒酒綜合征（附11例報告）[J]. 臨床神經病學雜志, 1999, 12(5): 303.
16. 　宋海東, 丁瑛, 沈鑒清, 等.曲唑酮與阿普唑侖治療酒精濫用后睡眠障礙的研究[J]．中國行為醫學科學, 2006, 15（5）：448.
17. 　何林海. 阿普唑侖聯合奮乃靜治療24例酒精戒斷綜合征的對照研究[J]. 中國民康醫學, 2011, 23(11): 1368-1369.
18. 　Wasilewski D, Matsumoto H, Kur E, et al. Assessment of diazepam loading dose therapy of delirium tremens[J]. Alcohol Alcohol, 1996, 31(3): 273-278．.

West China Medical Journal

Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery

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