Lindenbaum G A, Carroll S F, Daskal I, Kapusnick R
Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA 19141.
J Trauma. 1989 Dec;29(12):1654-8. doi: 10.1097/00005373-198912000-00012.
Alcohol continues to play a major etiologic role in blunt trauma. It is involved in 65-70% of fatal highway crashes. The role of illicit drugs, although accepted as an etiologic factor in trauma, is less well described. This is especially true of blunt and penetrating trauma related to violent crime. During a 9-month period, in a randomly selected group, blood and urine samples were taken from 169 traumatized patients for alcohol and general toxicology screens. There were 81 cases (47.9%) related to violent crime. One hundred twenty-six patients (74.5%) tested positive for illicit or prescription drugs in their blood. These included cocaine (54.4%), cannabinoids (37.2%), barbiturates (7.1%), amphetamines (4.7%), benzodiazepines (10.1%), opiates (9%), and codeine (1%). Sixty-one patients (35.5%) tested positive for alcohol. Alcohol was found in 6.2% of violent crime-related cases. Illicit drugs were found in 80.3% of violent crime-related cases. Alcohol and drugs, especially illicit drugs, are major etiologic factors in both accidental and crime-related trauma in the urban population. All patients admitted to trauma centers, especially urban trauma centers, should be screened for alcohol and drugs.
酒精在钝器伤中仍然是一个主要的病因。65 - 70%的致命高速公路车祸都与酒精有关。非法药物虽然被公认为创伤的一个病因，但相关描述较少。对于与暴力犯罪相关的钝器伤和穿透伤尤其如此。在9个月的时间里，从一个随机抽取的169名创伤患者组中采集血液和尿液样本进行酒精和一般毒理学筛查。其中81例（47.9%）与暴力犯罪有关。126名患者（74.5%）血液中非法或处方药检测呈阳性。这些药物包括可卡因（54.4%）、大麻素（37.2%）、巴比妥类药物（7.1%）、苯丙胺（4.7%）、苯二氮䓬类药物（10.1%）、阿片类药物（9%）和可待因（1%）。61名患者（35.5%）酒精检测呈阳性。在6.2%与暴力犯罪相关的病例中发现了酒精。在80.3%与暴力犯罪相关的病例中发现了非法药物。酒精和药物，尤其是非法药物，是城市人口意外创伤和与犯罪相关创伤的主要病因。所有入住创伤中心的患者，尤其是城市创伤中心的患者，都应该进行酒精和药物筛查。
