目的：观察慢性酒精中毒所致震颤谵妄的临床特点及预后。方法：对32例慢性酒精中毒所致震颤谵妄患者的临床资料进行回顾性分析，探讨其临床特点及预后。结果：32例患者中，因应激方式不当饮酒者19例，平均饮酒年龄20.3±9.6年，平均每日摄入乙醇量276.4±21.9 g。因戒断而出现临床症状者15例。临床表现为多种精神症状和不同程度的意识障碍，伴有肢体震颤。头部CT扫描发现脑萎缩者30例。经治疗后症状痊愈者25人，好转者4人。结论：慢性酒精中毒所致震颤谵妄发作的病理生理机制尚不明了，但其发作与戒断关系密切，经积极干预可获得较满意的预后。
Objective To investigate the influence of chronic alcohol ingestion on the severity of acute lung injury (ALI) induced by oleic acid and lipopolysaccharide (LPS).Methods Thirty-two SD rats were randomly administrated with alcohol or water for 6 weeks，then instilled with oleic acid and LPS to induce ALI or with normal saline as control.Thus the rats were randomly divided into two injury groups [ethanol group and water group] and two control groups [ethanol group and water group] (n=8 in each group). PaO2,Wet to dry lung weight ratio (W/D)，levels of γ-glutamylcysteinylglycine (GSH) and malonaldehyde (MDA) in the lung tissue were measured.Results Compared to corresponding control groups，the PaO2 and GSH significantly decreased，and the lung W/D and MDA level were significantly increased in the injury groups (all Plt;0.05).In the injury groups，the changes of above parameters were more significant in the alcohol group than thoe in the water group (all Plt;0.05)，except the lung W/D with no significant difference.Conclusion Chronic ethanol ingestion was relevalent to oxidation/ antioxidation imbalance and more severe lung injury in rats with severe septic after trauma,which suggests that chronic alcohol abuse could increase the severity of acute lung injury.
Objective To evaluate the effectiveness of Xingnaojing (XNJ) injection in the treatment of acute alcohol intoxication. Methods The Cochrane library (Issue 4, 2008), MEDLINE (1989 to 2008), WANFANG database (1991 to 2008), CBM (1991 to 2008), and CNKI (1991 to 2008) were searched. The quality of included studies was assessed according to the criteria recommended Cochrane Collaboration.Meta-analyses were performed using RevMan 4.2.2 software. Results Twenty seven trials, all published in China were included. The quality of these studies was low. Meta-analyses showed that normal treatment plus XNJ could significantly shorten action time [WMD= – 90.62 min, 95%CI (– 121.12, – 60.11)] and effective time [WMD= – 124.97 min, 95%CI (– 183.54, – 66.40)]. Normal treatment plus XNJ was similar with normal treatment plus naloxone in action time. No significant differences were observed in effective time between naloxone and XNJ. Conclusions It shows that XNJ injection plus western medical therapy is superior to western medical therapy. The curative efficacy of XNJ and Naloxone was similar.
目的:探讨使用院前指数(Prehospital Index, PHI)及格拉斯哥昏迷评分(Glasgow Coma Score, GCS)两种创伤评分法对院前急救中急性酒精中毒合并外伤性颅内出血患者的评估价值。方法: 纳入68例院前急救中酒精中毒合并头外伤患者,院前均进行PHI及GCS两种创伤评分,随访至出院,以头部CT扫描及随访结果作为标准以判断患者是否伴有颅内出血。计算两种创伤评分的敏感度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值及Youden指数,并作出受试者工作特征曲线(ROC曲线),以正态离差值Z检验两种评分法ROC曲线下面积的差异。 结果: 院前指数以6分作为诊断界值,敏感度为94.7%,特异度为71.4%;格拉斯哥昏迷评分以9分作为诊断界值,敏感度为98.8%,特异度为30.6%,PHI及GCS的ROC曲线下面积分别是0.881和0.678,其差异有统计学意义。结论: 在对急性酒精中毒合并头外伤患者是否伴有颅内出血的院前评估中,院前指数较格拉斯哥昏迷评分更有价值。
摘要:目的:探讨纳络酮对急性酒精中毒的临床疗效及经验。方法: 将58例酒精中毒患者随机分为2组:常规治疗组29例,给予利尿剂、胃肠黏膜保护剂及静脉补液对症治疗;纳络酮治疗组29例,除了应用常规治疗方法外,加用纳络酮。结果:纳络酮治疗组患者症状改善,清醒时间明显提前于对照组(Plt;0.01)。结论: 纳络酮治疗急性酒精中毒疗效肯定、使用简单安全,值得临床推广使用。Abstract: Objective: To evaluate the clinical effect of naoxone on acute alcoholism. Methods: Fiftyeight cases of acute alcoholism were randomly divided into two groups: remedial group (29 cases) and the comparison group (29 cases). Both groups were given diuretic, protection of mucous membrane of stomach and fluid infusion. The remedial group was treated with naloxone. Results: Symptoms of the remedial group were obviously improved. Consciousness was regained much earlier than that of the comparison group (Plt;0.01). Conclusion: Naloxone can be used effectively and safely in treating acute alcoholism.
摘要:目的:探讨加兰他敏对急性酒精中毒大鼠海马神经元N甲基D天冬氨酸(NMDA)·R2B的影响。 方法:将60只大鼠分为对照组、酒精组及加兰他敏组,每组各20只。酒精组以50％(v/v) 酒精12 mL/kg灌胃两次/日,共7d。加兰他敏组酒精(浓度、剂量同上)灌胃的同时腹腔注射加兰他敏2mg/kg一次/日,共7d。对照组以等量生理盐水灌胃。实验第8天取大鼠海马区做苏木精伊红（HE）染色,观察海马区的病理学变化;免疫组织化学采用SABC法,观察海马区神经元NR2B的表达。 结果: 病理学观察结果：对照组海马区神经细胞排列整齐,胞质淡染,无变性、坏死;酒精组神经细胞层次不清、排列松散、细胞数量减少,部分细胞变性;加兰他敏组神经细胞层次较清、排列较密,细胞数目较酒精组增; 免疫组织化学结果：酒精组与对照组比较NR2B阳性表达细胞数量明显减少(Plt;0.01);加兰他敏组与酒精组比较NR2B阳性表达细胞数量明显增高(Plt;0.05);加兰他敏组与对照组比较NR2B表达细胞数量无明显差异(Pgt;005)。 结论: 急性酒精中毒与海马区神经细胞的NR2B表达下调有关;加兰他敏具有保护急性酒精中毒导致的大鼠海马区神经细胞毒性的作用,其机制可能与加兰他敏上调NR2B的表达有关。Abstract: Objective: To study the effects of galanthamine on NmethylDaspartic acid receptor 2B (NMDAR2B, NR2B) in the hippocampus (HIP) of acute alcoholism rats. Methods: Total of 60 wistar male rats were randomly divided into control group, ethanol group and glanthamine group, and there were 20 rats in each group. The rats in ethanol group were given by intragastric administration with 50% alcohol (v/v) on the dose of 12 ml/kg twice per day, in control group were given by same dose of saline, and in galanthamine group were treated by intragastric administration with the same concentration and dosage of alcohol as in ethanol group and peritoneal injection with 2 mg/kg of galanthamine once per day for 7 days. In eighth day of experiment, the rats were sacrificed under etherization, and pathological changes of HIP’s zone of rat were observed by HEstaining, and expression of NR2B in neurons of HIP’s zone by immunohistochemical SABC method. Results: The results observed by histopathology showed that in control group, neurons of HIP’s zone lined up in order, cytoplasm had faint staining, and were no degeneration and necrosis; in ethanol group, nerve cells’ layer was unclear, structure was loose, cell number reduced and part of cells degenerated; in galanthamine group, layer of neurons was comparatively clear and arrangement was comparatively dense, and the cell number increased obviously more than ethanol group. The results detected by Immunohistochemistry for NR2B showed that the cell number with expression of NR2B in the HIP’s zone decreased significantly in the ethanol group than in the control group (Plt;0.01), increased in the galanthamine group than in the ethanol group (Plt;0.05), and had no difference between the galanthamin and control group (Pgt;0.05). Conclusion: Acute alcoholism may relate to down regulation of expression of neuron’s NR2B in HIP’s zone;The galanthamin has role of protection for neuron in HIP’s zone induced by toxicity of acute alcoholism, and its mechanism may relate to galanthamin upregulation NR2B expression.
ObjectiveTo explore the potential safety problems of acute alcohol intoxication. MethodsBetweenDecember 2009 and December 2012, 508 patients with acute alcohol intoxication were admitted to the Department ofEmergency of our hospital. We analyzed the potential safety problems of acute alcohol intoxication and made relative countermeasures. ResultsThe 508 cases of acute alcohol intoxication were treated with comprehensive measures, such as physical examination, health condition evaluation, airway patency maintaining, vein channel establishing, accelerating in vivo alcohol exclusion, maintaining consciousness, taking safety protective measures, and strengthening the communication between doctors and patients. There was no accident injury or death occurred. ConclusionWe should pay more attention to the potential safety problems of patients with acute alcohol intoxication, and take measures to ensure their safety.
Acute alcohol intoxication is one of the most common poisoning diseases in emergency departments. The main clinical manifestations are nervous system symptoms, with various comorbidities, hidden complications, and high risk of adverse events, and it often takes up more medical resources in emergency departments. This article summarizes the necessity, basis, and existing methods of clinical risk assessment for acute alcohol intoxication, in order to provide a reference for early identification of high-risk patients and optimization of management in emergency departments.