麻醉性肠道综合征
Narcotic bowel syndrome.
作者信息
Grover Casey A, Wiele Erik D, Close Reb J
机构信息
Stanford University/Kaiser Permanente Emergency Medicine Residency, Stanford University School of Medicine, Stanford, California 94305, USA.
出版信息
J Emerg Med. 2012 Dec;43(6):992-5. doi: 10.1016/j.jemermed.2011.05.025. Epub 2011 Jun 29.
BACKGROUND
Narcotic bowel syndrome is characterized by chronic or recurrent abdominal pain associated with escalating doses of narcotic pain medications. It may occur in as many as 4% of all patients taking opiates, and yet few physicians are aware that the syndrome exists.
OBJECTIVES
The objectives of this case report are to raise awareness of narcotic bowel syndrome among emergency physicians, as well as review the clinical features, diagnosis, pathophysiology, and emergency department (ED) management of the syndrome.
CASE REPORT
We report a case of narcotic bowel syndrome diagnosed in a 24-year-old woman after > 1 year of ED visits for recurrent abdominal pain of unknown origin.
CONCLUSIONS
It is particularly important for emergency physicians to be familiar with this syndrome, as many patients with narcotic bowel syndrome seek evaluation and treatment in the ED. Although the diagnosis is unlikely to be made in the ED, timely referral for evaluation of this syndrome may help patients to receive definitive treatment for their recurrent and chronic pain.
背景
麻醉性肠综合征的特征是慢性或复发性腹痛，且与麻醉性镇痛药剂量不断增加有关。在所有服用阿片类药物的患者中，该综合征的发生率可能高达4%，然而很少有医生意识到这种综合征的存在。
目的
本病例报告的目的是提高急诊医生对麻醉性肠综合征的认识，并回顾该综合征的临床特征、诊断、病理生理学及急诊科处理方法。
病例报告
我们报告一例麻醉性肠综合征病例，该病例为一名24岁女性，因不明原因的复发性腹痛在急诊科就诊1年多后被诊断为此病。
结论
急诊医生熟悉这种综合征尤为重要，因为许多麻醉性肠综合征患者会到急诊科寻求评估和治疗。虽然在急诊科不太可能做出诊断，但及时转诊以评估该综合征可能有助于患者接受针对其复发性和慢性疼痛的明确治疗。
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