20个国家/地区氯胺酮使用及管理情况的调查  

Investigation of ketamine use and management in 20 countries/regions

作　　者：马俊[1,2] 穆生财[3] 鲍彦平[2] 刘志民[2] MA Jun;MU Shengcai;BAO Yanping;LIU Zhimin(School of Public Health, Peking University, Beijing, 100191;National Institute on Drug Dependence, Peking University, Beijing, 100191;Shanxi Center for Disease Control and Prevention, Taiyuan, 030001)

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京大学中国药物依赖性研究所,北京100191 [3]山西省疾病预防控制中心,太原030001

出　　处：《中国药物依赖性杂志》2018年第2期118-124,共7页Chinese Journal of Drug Dependence

基　　金：十三五国家重点研发计划(2016YFC0800907)支持

摘　　要：目的:了解氯胺酮在国际上的使用、管理和滥用情况。方法:采用自拟问卷,于2015年6月-9月通过电子邮件的形式向国际麻醉品管制局(INCB)的成员国或地区发送调查问卷,收集氯胺酮目前在各国/地区的医疗使用、管理和滥用情况等内容,并于2015年9月15日收回20个国家/地区的反馈。结果:本次调查的20个国家/地区中,有14个来自欧洲,3个来自亚洲,各有1个分别来自北美洲、大洋洲和非洲。除了拉脱维亚,其余19个国家/地区目前均将氯胺酮作为麻醉药在临床使用,并且有12个(63.2%)国家/地区将其作为医疗机构中麻醉科主要使用的麻醉用药,但这些国家/地区均有可替代氯胺酮的其他药品。2012-2014年用于医疗目的的氯胺酮数量以摩尔多瓦、捷克、冰岛、土耳其、乌克兰五个国家为最多(>100 kg/年)。除五个国家/地区未作回答外,共13个国家/地区存在氯胺酮的滥用,其中10个为欧洲国家。这些国家/地区氯胺酮的主要来源以黑市走私贩运(8/13)和药品的非法流失(6/13)为主。2012-2014年查获非法来源的氯胺酮的数量较多(>100 kg/年)的国家/地区有摩尔多瓦、中国香港及克罗地亚。在20个国家/地区中,有13个国家/地区(占65%)将氯胺酮列入管制,并且其中8个国家/地区(66.7%)认为氯胺酮的管制没有对其临床使用造成影响。而将氯胺酮列管的主要原因是"预防其滥用"(12/13),"发生了流行性滥用"(6/13)及其"药品不良反应"(1/13)。结论:氯胺酮在绝大多数国家/地区仍作为麻醉药在临床使用,其滥用出现在以欧洲为主的多个国家/地区。在对氯胺酮进行管制的国家/地区中,氯胺酮的临床使用基本未受到影响。Objective： To understand the medical use, management and abuse of ketamine internationally.Methods： A self-designed questionnaire was sent to the member states of International Narcotics Control Board（ INCB） by email from June 2015 to September 2015,to collect information on the medical use,management and abuse of ketamine in these countries/regions. By the end of September15,2015,we received feedback from 20 countries/regions.Results： Of the 20 countries/regions,14 countries were from Europe,and 3 were from Asia. The other three countries were from North America,Oceania and Africa respectively. Except for Latvia,ketamine was used as an anesthetic in 19 countries/regions. 12（ 63. 2%） out of the 19 countries/regions used it as the main anesthetic drug in the anesthesiology department of medical institutions, but all these countries/regions have alternative anaesthetic. The consumption of ketamine for a medical use in 2012-2014 was higher in Moldova,the Czech Republic,Iceland,Turkey,and Ukraine（ 100 kg/year） than that in others. Ketamine abuse occurred in 13 out of 15 countries/regions that answered the questionnaire,of which 10 were European countries. And the main sources of ketamine were from smuggling/black market（ 8/13） and diversion from hospitals or pharmaceutical stores（ 6/13）. The quantity of ketamine seizure in Moldova,China-Hong Kong and Croatia in 2012-2014 was higher than 100 kg/year. Ketamine was placed under national control in 13 out of the 20 countries/regions（ 65%）,and 8 of them（ 66. 7%） believed that the control of ketamine did not affect its clinical use. The main reasons for the regulation of ketamine were ＂to prevent the potential abuse＂（ 12/13）,＂to control the abuse of ketamine＂（ 6/13） and ＂for its side-effects＂（ 1/13）.Conclusion： Ketamine was used as an anesthetic clinically in most countries/regions.And ketamine abuse occurred in multiple countries/regions that were mainly from Europe. In countries/regions where ketamine was legall

关 键 词：氯胺酮 医疗使用 滥用 管制 

分 类 号：R181.3[医药卫生—流行病学]