食管癌术后酒精戒断综合征的防治  

Prevention and Treatment of Alcohol Withdrawal Syndrome aft er Esophageal Cancer Surgery

作　　者：薛杨[1] 罗澍[2] 孙小康[1] 赵长明[1] 郭向东[1] 

机构地区：[1]德阳市人民医院心胸外科 [2]德阳市人民医院神经内科

出　　处：《华西医学》2012年第11期1638-1640,共3页West China Medical Journal

摘　　要：目的探讨食管癌术后酒精戒断综合征的原因及有效预防治疗措施。方法 2000年1月-2011年10月共行食管癌手术935例,术后发生酒精戒断综合征16例,患者均为男性,年龄41～67岁,平均54岁。饮酒史16～47年,平均27.8年;每日饮白酒量为250～1 000 g,酒精含量162～590 g,平均321.5 g。所有患者均符合中国精神疾病分类与诊断标准第3版(CCMD-3)酒精戒断综合征诊断标准。在食管癌常规术后治疗的基础上,根据患者谵妄、烦躁、精神失常、昏迷等不同情况应用维生素B族、纳络酮、氟哌啶醇、氯丙嗪、安定、促进脑细胞代谢及补充能量等综合治疗,必要时予以镇静后气管插管呼吸机辅助呼吸。结果患者经治疗后戒断症状均完全消失,治疗时间2～10 d,平均5.3 d。13例获随访,随访时间4～18个月,均完全戒酒,其中1例术后8个月死于急性心肌梗死;余12例均恢复良好,且未出现酒精戒断症状。结论经合理有效的围手术期处理,食管癌术后酒精戒断综合征发生率可明显降低,详细询问病史,术前术后积极预防并及时给予有效的治疗是治愈的关键。Objective To investigate the causes,prevention and treatment of alcohol withdrawal syndrome after esophageal cancer surgery.Methods From January 2000 to October 2011,935 surgeries for esophageal cancer were performed,among which 16 patients had postoperative complications of alcohol withdrawal syndrome.All the 16 patients were male,aged between 41 to 67 years old,averaging at 54.Drinking histories ranged from 16 to 47 years with an average of 27.8 years.Daily liquor quantity ranged from 250 to 1 000 g,and the alcohol content was from 162 to 590 g,averaging 321.5 g.All patients were in accordance with the diagnosis standard of alcohol withdrawal syndrome in the Chinese Spirit Disease Classification and Diagnosis Standard Third Edition（CCMD-3）.In addition to conventional treatment,based on the delirium,irritability,mental disorders,and coma of the patients,we administered B vitamins,naloxone,haloperidol, chlorpromazine,and diazepam to promote brain cell metabolism and energy of the patients,and when necessary, endotracheal intubation for assisted mechanical ventilation was used after sedation.Results The withdrawal symptoms totally disappeared after treatment.The treatment time varied from 2 to 10 days with an average of 3.5 days.Thirteen patients were followed up with a time period from 4 to 18 months.All of them achieved abstinence from alcohol.One patient died from acute myocardial infarction eight months after surgery.All the other twelve patients recovered well with complete abstinence from alcohol and no recurrence of withdrawal symptoms.Conclusions Reasonable and effective perioperative treatment can significantly lower the incidence of alcohol withdrawal syndrome.Detailed history of the patients,preoperative and postoperative active prevention and timely and effective treatment are the key to healing.

关 键 词：食管癌 酒精戒断综合征 防治 

分 类 号：R735.1[医药卫生—肿瘤]