海洛因成瘾者美沙酮维持治疗现状及偷吸行为的影响因素分析  

Influencing factors on Heroin lapse of methadone maintenance treatment outpatient

作　　者：廖蕊 龚毅[2] 韩佳禹 余彬 董佩杰 杨诗凡 杨淑娟[1] LIAO Rui;GONG Yi;HAN Jia-yu;YU bin;DONG Pei-jie;YANG Shi-fan;YANG Shu-juan(Department of Health and Social Behavior,West China school of Public Health,Sichuan Univercity,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院健康与社会行为学系,四川成都610041 [2]四川省疾病预防控制中心,四川成都610041

出　　处：《现代预防医学》2020年第15期2789-2792,2861,共5页Modern Preventive Medicine

基　　金：四川省卫计委艾滋病防治项目“四川省美沙酮维持治疗工作成效综合评估”(H180809);四川省性社会学与性教育研究中心(SXJYC1806)。

摘　　要：目的分析四川省美沙酮维持治疗门诊患者社会人口学特征、既往毒品使用、美沙酮治疗现状对偷吸行为的影响,为降低美沙酮维持治疗海洛因偷吸率提供科学依据和参考。方法对四川省5个美沙酮门诊点的患者进行面对面问卷调查,将581份有效问卷进行单因素检验和多因素logistic回归分析,研究患者海洛因偷吸行为的影响因素。结果调查对象中有过海洛因偷吸行为180人,海洛因偷吸率31.0%,男性(OR=1.643,95%CI:1.038~2.601)、使用海洛因年限长("11~20年"与"<10"年相比OR=1.866,95%CI:1.167~2.983;">20年"与"<10年"相比OR=2.376,95%CI:1.282~4.404)、曾服用过新型毒品(OR=2.181,95%CI:1.415~3.363)、美沙酮治疗时间长(">10年"与"≤5年"相比OR=1.904,95%CI:1.909~3.326)是海洛因偷吸行为危险因素。结论美沙酮维持治疗门诊应重点关注上述人群,让患者明确毒品危害及美沙酮维持治疗的必要性,同时给予心理辅导以改善心理缺陷状态,以减少治疗期间的海洛因偷吸行为。Objective To study the influencing factors on Heroin steal taking of patients’general demographic characteristics,drug use history and methadone maintenance treatment condition in MMT outpatients in Sichuan Province as a scientific basis and reference for reducing the rate of heroin lapse.Methods All the outpatients were selected as research objects in 5 MMT clinics chosen by stratified clustered sampling method to accept face-to-face questionnaire surveys.Investigate the influencing factors on heroin lapse by using single factor analysis and Logistic regression by means of 581 effective questionnaires.Results 180 cases used heroin during the methadone maintenance treatment.The rate of heroin lapse is 31.0%.The results of Logistic regression showed that male(OR=1.643,95%CI:1.038-2.601),long years of heroin abuse("11-20 years"vs"<10 years",OR=1.866,95%CI:1.167-2.983;">20 years"vs"<10 years",OR=2.376,95%CI:1.282-4.404),used to use other drugs(OR=2.181,95%CI:1.415-3.363)and a long-time treatment in MMT(">10 years"vs"≤5 years",OR=1.904,95%CI:1.909-3.326)are the risk factors of heroin lapse.Conclusion MMT clinics should focus on the above-mentioned population,so that patients can identify the serious harm of drugs and the necessity of methadone maintenance treatment.Meanwhile,provide psychological counseling to improve the state of mental defects and reduce heroin lapse during treatment.

关 键 词：美沙酮维持治疗 海洛因偷吸行为 影响因素 

分 类 号：R749.64[医药卫生—神经病学与精神病学] R181.3[医药卫生—临床医学]