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。
Objective To summarize the treatment and outcomes of patients with multiple injuries combined with thoracic trauma following the Wenchuan earthquake. Methods The wounded patients admitted from 12th to 31st May with multiple injuries combined with thoracic trauma after the earthquake were retrospectively analyzed. This includes baseline information, treatments, outcomes and deaths. Results Liver repair, spleen abscission, decompression and removed of intracranial hematoma ranked the first three of the main reasons for the emergency surgery death of multiple injuries. Heart-lung machine support, trachea cannula and closed drainage of thoracic cavity ranked the first three of the main reasons for the death of thoracic trauma. Moreover, ARDS, fracture of sternum and flail chest ranked the first three of the main reasons for the death of other multiple injuries. All the casualties had the worst situation with high ISS scores. The main death reasons were cerebral wound, peritoneum viscera injuries and the four limbs and pelvis injuries. Besides, the severe thoracic trauma accelerated their death. Conclusion Main death reasons for the inpatients with multiple injuries combined with thoracic trauma are hemorrhagic shock and severe cerebral wound. The thoracic trauma degree will increase the risk of their death. The more the injury positions, the higher ISS scores, and the more serious thoracic trauma, the higher mortality rate. Rapid examination and diagnosis, rapied triage and distribution of thoracic trauma can help to create more chances for the further treatment and increase the success rate of rescue.