静脉滴注 0.9% 氯化钠治疗不会缩短急诊科酒精中毒患者的住院时间：一项随机对照试验。
Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: a randomised controlled trial.
机构信息
Department of Emergency Medicine, Gold Coast Hospital, Southport, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
出版信息
Emerg Med Australas. 2013 Dec;25(6):527-34. doi: 10.1111/1742-6723.12151. Epub 2013 Nov 8.
BACKGROUND
I.v. 0.9% sodium chloride (normal saline) is frequently used to treat ED patients with acute alcohol intoxication despite the lack of evidence for its efficacy.
OBJECTIVE
The study aims to compare treatment with i.v. normal saline and observation with observation alone in ED patients with acute alcohol intoxication.
METHODS
A single-blind, randomised, controlled trial was conducted to compare a single bolus of 20 mL/kg i.v. normal saline plus observation with observation alone. One hundred and forty-four ED patients with uncomplicated acute alcohol intoxication were included. The study was conducted in one tertiary and one urban ED in Queensland, Australia. Primary outcome was ED length of stay (EDLOS). Secondary outcomes were treatment time, breath alcohol levels, intoxication symptom score, level of intoxication and associated healthcare costs.
RESULTS
Both groups were comparable at baseline: blood alcohol content (BAC) was similar between treatment and control groups (0.20 % BAC vs 0.19 % BAC, P = 0.44) as were initial intoxication symptom scores (22.0 vs 22.3, P = 0.90). Both groups had a similar EDLOS (287 min vs 274 min, P = 0.89; difference 13 min [95% CI -37-63]) and treatment time (244 min vs 232 min, P = 0.94; difference 12 min [95% CI -31-55]). Change of breath alcohol levels, intoxication score and level of intoxication were not significantly different between the two groups. Patients in the treatment group had an additional healthcare cost of A$31.92 compared with control.
CONCLUSIONS
I.v. normal saline therapy added to observation alone does not decrease ED length of stay compared with observation alone. Intoxication symptom scores and general state of intoxication were similar in both groups. The present study suggests that either approach is reasonable, but observation alone might be preferred as it is less resource intensive.
背景
尽管缺乏疗效证据，静脉注射 0.9%氯化钠（生理盐水）仍常被用于治疗急性酒精中毒的 ED 患者。
目的
本研究旨在比较静脉注射生理盐水治疗与单纯观察治疗对 ED 中急性酒精中毒患者的效果。
方法
采用单盲、随机、对照试验，比较了静脉注射生理盐水单次推注 20mL/kg 加观察与单纯观察的效果。纳入了 144 例无并发症的急性酒精中毒 ED 患者。该研究在澳大利亚昆士兰州的一家三级医院和一家城市 ED 进行。主要结局是 ED 停留时间（EDLOS）。次要结局为治疗时间、呼气酒精水平、中毒症状评分、中毒程度和相关医疗保健费用。
结果
两组患者基线时具有可比性：治疗组和对照组的血液酒精含量（BAC）相似（0.20% BAC 与 0.19% BAC，P=0.44），初始中毒症状评分也相似（22.0 与 22.3，P=0.90）。两组的 EDLOS 相似（287min 与 274min，P=0.89；差值 13min[95%CI-37-63]），治疗时间也相似（244min 与 232min，P=0.94；差值 12min[95%CI-31-55]）。两组间呼气酒精水平、中毒评分和中毒程度的变化无显著差异。与对照组相比，治疗组患者的额外医疗保健费用为 31.92 澳元。
结论
与单纯观察相比，静脉注射生理盐水治疗加观察并不能缩短 ED 停留时间。两组的中毒症状评分和总体中毒状态相似。本研究表明，两种方法都合理，但单纯观察可能更具优势，因为它的资源需求较少。
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