Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery_West China Medical Journal

Authors：

XUE Yang ¹ , LUO Shu ² , SUN Xiaokang ¹ , ZHAO Changming ¹ , GUO Xiangdong ¹

1. Department of Cardiothoracic Surgery; 2. Department of Internal Neurology; People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

Keywords：

食管癌; 酒精戒断综合征; 防治

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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。

Citation： XUE Yang,LUO Shu,SUN Xiaokang,ZHAO Changming,GUO Xiangdong. Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery. West China Medical Journal, 2012, 27(11): 1638-1640. doi: Copy

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1. 　林兆耆, 戴自英.实用内科学（下册）[M].北京: 人民卫生出版社, 1986: 2133.
2. 　陈考珍, 顾柏林, 俞永宝.戒酒综合征23例分析[J].卒中与神经疾病杂志, 2002, 19(2): 120.
3. 　Adinoff B. Double-blind study of alprazolam, diazepam, clonidine, and placebo in the alcohol withdrawal syndrome: preliminary findings[J]. Alcohol Clin Exp Res, 1994, 18(4): 873-878.
4. 　Banks WA, KastinAJ. Brain-to-blood transport of peptides and the alcohol withdrawal syndrome [J]. Ann N Y Acad Sci, 1994, 739: 108-118.
5. 　Sanna E, Talani G, Busonero F, et al. Brain steroidogenesis mediates ethanol modulation of GABAA receptor activity in rat hippocampus[J]. J Neurol Sci, 2004, 24(29): 6521-6530．.
6. 　Kumar S, Fleming RL, Morrow AL. Ethanol regulation of gaminobutyric acid A receptors：genomic and nongenomic mechanisms[J]. Pharmacol Ther, 2004, 101(3): 211-226．.
7. 　Hasegawa D, Matsuki N, Fujita M, et al. Kinetics of glutamate and aminobutyric acid in cerebrospinal fluid in acanine model of complex partial status epilepticus induced by kainic acid[J]. J Vet Med Sci, 2004, 66(12): 1555-1559．.
8. 　Loup F, Wiester HG, Yonekawa Y, et al. Selective alterations in GABAa receptor subtypes in human temporal lobe epilepsy[J]. J Neurol Sci, 2000, 20(14): 5401-5419．.
9. 　Blaesse P, Airaksinen MS, Rivera C, et al. Cation-chloride cotransporters and neuronal function[J]. Neuron, 2009, 61(6): 820-838．.
10. 　汤宜朗.酒中毒与戒酒综合征的表现与治疗[J].中国实用内科杂志, 1997, 17(11): 689-691.
11. 　陈彦方, 杨德森, 姚芳传, 等.中国精神疾病分类与诊断标准（CCMD-3）[M].济南: 山东科学技术出版社, 2001: 62-74.
12. 　Nordentoft M, Timm S, Hasselbalch E, et al. Thiamine pyrophosphate effect and erythrocyte transketolase activity during severe alcohol withdrawal syndrome[J]. Acta Psychiatr Scand, 1993, 88(2): 80-84.
13. 　张会莲. 警惕酒瘾患者急性戒酒诱发酒精戒断综合征[J]. 临床误诊误治, 2010, 23(11): 1008-1009.
14. 　汪建华, 龚云, 刘业, 等. 酒精戒断性癫痫9例临床分析[J]. 重庆医学, 2012, 41(13): 1324-1325.
15. 　郭建一.住院停止饮酒诱发戒酒综合征（附11例报告）[J]. 临床神经病学杂志, 1999, 12(5): 303.
16. 　宋海东, 丁瑛, 沈鉴清, 等.曲唑酮与阿普唑仑治疗酒精滥用后睡眠障碍的研究[J]．中国行为医学科学, 2006, 15（5）：448.
17. 　何林海. 阿普唑仑联合奋乃静治疗24例酒精戒断综合征的对照研究[J]. 中国民康医学, 2011, 23(11): 1368-1369.
18. 　Wasilewski D, Matsumoto H, Kur E, et al. Assessment of diazepam loading dose therapy of delirium tremens[J]. Alcohol Alcohol, 1996, 31(3): 273-278．.

West China Medical Journal

Prevention and Treatment of Alcohol Withdrawal Syndrome after Esophageal Cancer Surgery

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