Division of Upper Gastrointestinal and Metabolic Surgery, Department of Surgery, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
J Dig Dis. 2017 Sep;18(9):504-510. doi: 10.1111/1751-2980.12512.
Evaluations of upper gastrointestinal toxicity from ketamine abuse are uncommon. This study investigated the clinical pattern of upper gastrointestinal symptoms in patients inhaling ketamine.
In a cross-sectional study of 611 consecutive patients who were seeking treatment for ketamine uropathy in a tertiary hospital setting between August 2008 and June 2016, their clinical pattern of upper gastrointestinal symptoms was evaluated and compared with a control population of 804 non-users.
A total of 168 (27.5%) patients abusing ketamine (mean age 26.3 years, 58.9% female) reported the presence of upper gastrointestinal symptoms. These symptoms were significantly more prevalent in patients inhaling ketamine than in those who were not (27.5% vs 5.2%, P < 0.001). Their mean duration of ketamine abuse before symptom presentation was 5.0 ± 3.1 years. The presenting symptoms included epigastric pain (n = 155, 25.4%), recurrent vomiting (n = 48, 7.9%), anemia (n = 36, 5.9%) and gastrointestinal bleeding (n = 20, 3.3%). Uropathy symptoms were preceded by upper gastrointestinal symptoms for 4.4 ± 3.0 years in 141 (83.9%) patients. Logistic regression showed that elder age (odds ratio [OR] 1.06, P = 0.04), active abuser status (OR 1.60, P = 0.04) and longer duration of ketamine abuse (OR 1.00, P = 0.04) were independent factors associated with upper gastrointestinal toxicity.
Although epigastric symptoms are unusual in the young population, upper gastrointestinal toxicity was highly prevalent in those inhaling ketamine. Enquiries about ketamine abuse are recommended when assessing young patients with epigastric symptoms.
评估氯胺酮滥用引起的上消化道毒性并不常见。本研究调查了吸入氯胺酮的患者上消化道症状的临床模式。
在 2008 年 8 月至 2016 年 6 月期间，在一家三级医院对 611 例连续因氯胺酮尿路病就诊的患者进行了一项横断面研究，评估了他们上消化道症状的临床模式，并与 804 名非使用者的对照组进行了比较。
共有 168 名（27.5%）滥用氯胺酮的患者（平均年龄 26.3 岁，58.9%为女性）报告存在上消化道症状。与未吸入氯胺酮的患者相比，吸入氯胺酮的患者中这些症状更为常见（27.5%比 5.2%，P < 0.001）。他们在出现症状前滥用氯胺酮的平均时间为 5.0 ± 3.1 年。主要表现症状包括上腹痛（n = 155，25.4%）、反复呕吐（n = 48，7.9%）、贫血（n = 36，5.9%）和胃肠道出血（n = 20，3.3%）。在 141 名（83.9%）患者中，尿路病症状之前先出现上消化道症状，时间间隔为 4.4 ± 3.0 年。Logistic 回归显示，年龄较大（比值比[OR] 1.06，P = 0.04）、活跃滥用者（OR 1.60，P = 0.04）和较长的氯胺酮滥用时间（OR 1.00，P = 0.04）是与上消化道毒性相关的独立因素。
尽管在上消化道症状在年轻人群中并不常见，但吸入氯胺酮的人群中，上消化道毒性的发生率很高。在评估有上腹痛的年轻患者时，建议询问氯胺酮滥用情况。
