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[酒精中毒]

[Alcohol intoxication].

作者信息

Roldán J, Frauca C, Dueñas A

机构信息

Servicio de Medicina Intensiva, Hospital de Navarra, Irunlarrea 3, 31008 Pamplona, Spain.

出版信息

An Sist Sanit Navar. 2003;26 Suppl 1:129-39.

Abstract

Alcohol intoxication is the principal drug addiction in many countries of the world. It affects all age groups, both sexes and almost all social groups. Mortality associated with acute alcohol poisoning on its own is exceptional, but it can be an important factor if it coexists with recreational drugs. It is directly responsible for more than half of traffic accidents. Diagnosis is easy by means of anamnesis and clinical examination, and can be confirmed by determining the level of ethanol in the bloodstream. Supportive care is the best therapy in order to protect the patient from secondary complications. Methanol, or alcohol fuel, is used as a solvent, and can also be found as an adulterant of alcoholic drinks. Poisoning by oral means is the most frequent. Oxidized in the liver through dehydrogenase enzyme alcohol, toxicity is due to its metabolites, formaldehyde and formic acid. The clinical picture basically consists of cephalea, nausea, vomiting, hypotension and depression of the central nervous system. The optic nerve is especially sensitive, with total and irreversible blindness as a possible result. Ethylenglicol is used as a solvent and as an antifreeze; toxicity is due to an accumulation of its metabolites. The clinical picture includes symptoms that are held in common with methylalcohol intoxication. Kidney failure due to tubular necrosis and the deposit of oxalate crystals can occur.

摘要

酒精中毒是世界上许多国家主要的药物成瘾问题。它影响所有年龄组、男女以及几乎所有社会群体。单纯急性酒精中毒导致的死亡率并不常见,但如果与消遣性药物同时存在,它可能是一个重要因素。它直接导致超过一半的交通事故。通过问诊和临床检查很容易做出诊断,通过测定血液中的乙醇水平可以确诊。支持性护理是最好的治疗方法,以保护患者免受继发性并发症的影响。甲醇,即酒精燃料,用作溶剂,也可作为酒精饮料的掺假物。经口服中毒最为常见。通过肝脏中的脱氢酶酒精氧化,毒性归因于其代谢产物甲醛和甲酸。临床表现主要包括头痛、恶心、呕吐、低血压和中枢神经系统抑制。视神经特别敏感,可能导致完全不可逆的失明。乙二醇用作溶剂和防冻剂;毒性归因于其代谢产物的积累。临床表现包括与甲醇中毒相同的症状。可能会发生由于肾小管坏死和草酸盐晶体沉积导致的肾衰竭。

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