Department of Emergency Medicine, School of Medicine, University of California, Davis, 4150 V Street, PSSB 2100, Sacramento, CA, 95817, USA,
Clin Rev Allergy Immunol. 2014 Feb;46(1):19-33. doi: 10.1007/s12016-013-8371-1.
Educational campaigns and legislative actions may have led to an overall decrease in the prevalence of volatile substance misuse (VSM) in many countries; however, it is still a common practice throughout the world. Studies currently suggest that girls are misusing volatile substances more than before and at a prevalence rate equal to or exceeding that of boys in several countries. Products that may be misused are ubiquitous and relatively easy to acquire. The most commonly misused substances in recent studies are fuels such as butane or petrol and compressed gas dusters and deodorants that may contain fluorocarbons and/or butane. Detection of VSM is challenging, therefore physicians must maintain a high level of suspicion based on history and clinical presentation. Clues to misuse are often subtle and may include the patient's proximity to a volatile substance or paraphernalia when found intoxicated, dermal burns, blisters, pigments, or rashes, and chemical odors. The primary targets of toxicity are the brain and the heart. The leading cause of death from VSM is from ventricular dysrhythmias. Treatment of toxicity begins with support of airway, breathing, and circulation. Exogenous catecholamines should be avoided if possible due to the theoretical "sensitized" and irritable myocardium. In the case of ventricular dysrhythmias, direct current defibrillation and/or beta-adrenergic receptor antagonism should be used. New evidence demonstrates the addictive potential of VSM yet effective therapy remains uncertain. Further research is needed in developing methods for preventing, detecting, and treating the harmful effects of VSM.
教育活动和立法行动可能导致许多国家挥发性物质滥用（VSM）的流行率总体下降；然而，它在全世界仍然是一种常见的做法。目前的研究表明，女孩比以前更频繁地滥用挥发性物质，而且在一些国家，其滥用率与男孩相等或超过男孩。可能被滥用的产品无处不在，而且相对容易获得。最近的研究中最常被滥用的物质是燃料，如丁烷或汽油，以及含有氟碳化合物和/或丁烷的压缩气体喷雾器和除臭剂。VSM 的检测具有挑战性，因此医生必须根据病史和临床表现保持高度怀疑。滥用的线索往往很微妙，可能包括患者在中毒时靠近挥发性物质或相关用具、皮肤烧伤、水疱、色素沉着或皮疹以及化学气味。毒性的主要靶器官是大脑和心脏。VSM 导致死亡的主要原因是心室心律失常。治疗毒性从支持气道、呼吸和循环开始。如果可能，应避免使用外源性儿茶酚胺，因为理论上存在“敏感化”和易激惹的心肌。在出现心室心律失常的情况下，应使用直流电除颤和/或β-肾上腺素能受体拮抗剂。新的证据表明 VSM 具有成瘾潜力，但有效的治疗方法仍不确定。需要进一步研究开发预防、检测和治疗 VSM 有害影响的方法。
