Höjer J, Hulting J
Medicinska intensivvårdsavdelningen (MIVA), Södersjukhuset, Stockholm.
Nord Med. 1992;107(6-7):182-4.
Alcohol intoxication is the commonest cause of unconsciousness among patients admitted to hospital. Studies have shown that, of all acute admissions to medical wards, approximately 20 per cent are patients who are intoxicated or have alcohol-related damage. A study cited in the article showed patients in deep stupor generally to have a blood alcohol concentration above 70 mmol/l, and to be at increased risk of respiratory complications and aspiration of regurgitated stomach content. In cases of severe alcohol intoxication, treatment includes the following: freeing of the airways, perhaps combined with respiratory support; tracheobronchial lavage and aspiration, followed by antibiotic treatment; liberal parenteral thiamine administration; cramp, hypoglycaemia and muscle damage may require special measures; in the acute stage, cardiac arrhythmia usually normalizes without special antiarrhythmic treatment.
酒精中毒是入院患者意识丧失最常见的原因。研究表明,在所有入住内科病房的急性患者中,约20%是醉酒或有酒精相关损害的患者。文章引用的一项研究表明,深度昏迷的患者血液酒精浓度一般高于70 mmol/l,且发生呼吸并发症和误吸反流胃内容物的风险增加。在严重酒精中毒的情况下,治疗包括以下方面:开放气道,可能需要联合呼吸支持;气管支气管灌洗和抽吸,随后进行抗生素治疗;大量胃肠外给予硫胺素;抽筋、低血糖和肌肉损伤可能需要采取特殊措施;在急性期,心律失常通常无需特殊抗心律失常治疗即可恢复正常。