右美托咪定联合地西泮治疗发热的重度急性酒精戒断综合征一例  

Combination of dexmedetomidine and diazepam in treatment of a patient with severe alcohol withdrawal syndrome complicated with fever

作　　者：李燕玲[1] 符永玫[1] Li Yanling;Fu Yongmei(Department of Emergency Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院急诊科,广州510630

出　　处：《新医学》2023年第3期221-225,共5页Journal of New Medicine

摘　　要：长期酗酒者停止或者减量饮酒后会出现酒精戒断综合征,轻症者的症状包括肢体不自主颤抖、出汗、恶心呕吐、焦虑、睡眠障碍;重症者则会出现幻觉、震颤性抽搐甚至昏迷死亡。如果没有及时发现该病以及给予治疗,容易发展为重度酒精戒断综合征,是患者死亡的潜在原因。苯二氮䓬类药物是治疗酒精戒断综合征的首选药物,但在急性期大剂量单用该类药物患者的症状控制不完全,需联合使用其他药物。该文报道1例伴发热的急性酒精戒断综合征进展为重度酒精戒断综合征患者,其为41岁男性,使用右美托咪定联合长效苯二氮䓬类药物地西泮后最终病情得到控制,提示联合使用右美托咪定不仅可以减少地西泮用量,减少患者呼吸抑制发生率,并且能改善患者睡眠节律异常症状。Long-term alcoholic individuals may develop alcohol withdrawal syndrome(AWS)after abrupt cessation or reduction of alcohol intake.Mild symptoms include involuntary limb trembling,sweating,nausea and vomiting,anxiety and disorder of sleep rhythm,and severe signs consist of hallucination,delirium and even coma.AWS is likely to progress into severe AWS when unrecognized or untreated,which is a potential cause of death.Benzodiazepines are the optimal drugs for the treatment of AWS.Nevertheless,large-dose benzodiazepines alone fail to completely control the symptoms of acute-stage AWS,and it should be combined with other drugs when necessary.In this article,we reported one 41-year-old male case of acute AWS complicated with fever who progressed into severe AWS.The disease condition was finally controlled by combined use of dexmedetomidine and diazepam,a widely prescribed benzodiazepine.The diagnosis and treatment of this case prompt that dexmedetomidine can decrease the dosage of diazepam,ease respiratory depression and mitigate the disorder of sleep rhythm.

关 键 词：急性酒精戒断综合征 右美托咪定 地西泮 发热 

分 类 号：R749.62[医药卫生—神经病学与精神病学]