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[氯胺酮相关的尿路损伤]

[Ketamine-associated urinary tract damage].

作者信息

Chen Wei-hao, Guan Zhi-chen

机构信息

Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Aug 18;43(4):636-9.

Abstract

Ketamine is widely used as an anesthetic during surgical procedures in both animals and humans. As its unique effects of inducing the dissociative hallucinatory,vivid dreams, out-of-body experiences, and delirium, it has diverted from legitimate uses to the illicit drug market, and abusing ketamine has become a serious social problem. The abusers may use ketamine alone or mixe it with other drugs to get an intense pleasure. There are case reports from all over the world in recent years that abusing ketamine may induce severe lower urinary tract symptoms (LUTS), and a variety of anatomical and functional lesions can be found in the urinary tract if further examinations are administrated. There is no universally recognized treatment protocols for this syndrome. Ketamine cessation or even reduction is the most effective treatment to prevent deterioration of the urinary tract, and intravesical instillation of hyaluranic acid (cystitstat) and oral pentosan polysulphate (elmiron) may take effect. The pathogenesis of ketamine-associated urinary tract destruction is unclear, and further study is needed.

摘要

氯胺酮在动物和人类的外科手术中被广泛用作麻醉剂。由于其具有诱导分离性幻觉、生动梦境、体外体验和谵妄等独特作用,它已从合法用途转向非法毒品市场,滥用氯胺酮已成为一个严重的社会问题。滥用者可能单独使用氯胺酮,或与其他药物混合使用以获得强烈快感。近年来,世界各地都有病例报告称,滥用氯胺酮可能导致严重的下尿路症状(LUTS),如果进一步检查,可在尿路中发现各种解剖和功能病变。对于这种综合征,尚无普遍认可的治疗方案。停止使用甚至减少氯胺酮是预防尿路恶化的最有效治疗方法,膀胱内灌注透明质酸(cystitstat)和口服聚多卡醇(爱脉朗)可能会有效果。氯胺酮相关尿路破坏的发病机制尚不清楚,需要进一步研究。

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