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体内藏毒者和体内填塞者的急诊科管理

Emergency department management of body packers and body stuffers.

作者信息

Heymann-Maier Liv, Trueb Lionel, Schmidt Sabine, Carron Pierre-Nicolas, Hugli Olivier, Heymann Eric, Yersin Bertrand

机构信息

Emergency service, University of Lausanne Medical Centre (CHUV), Lausanne, Switzerland.

出版信息

Swiss Med Wkly. 2017 Sep 12;147:w14499. doi: 10.4414/smw.2017.14499. eCollection 2017.

Abstract

Trafficking and sale of narcotics frequently involves the intra-abdominal transport of large quantities of drugs, usually cocaine or heroin ("body packing"), or, when there is a risk of being arrested, the oral ingestion of minor quantities of narcotics dedicated for immediate resale ("body stuffing"). This study aimed to describe the characteristics, complications and medical follow through of 132 cases of body packing (n = 36), cases of body stuffing (n = 83) or mixed cases (n = 13), referred by the authorities to our emergency department over the course of 12 years. Analysis of these 132 cases did not reveal any intra-abdominal rupture or leak of the packaging, or any case of acute intoxication. Nevertheless, a surgical intervention was required in three of the body packers (2.3%) owing to stasis of the packages inside the stomach. The mean length of stay was longer when the packets were located in the stomach at time of diagnosis than when they were lower in the gastrointestinal tract (61.9 vs 43.8 hours, respectively), but this was not statistically significant (p = 0.13). Length of stay was not associated with the presence of (nonspecific) symptoms or the total number of packs ingested. In conclusion, the study of this cohort of 132 body packers and body stuffers permits us to state that the medical management of these patients is rarely associated with serious complications, and that their length of stay is generally long, averaging 2 days before complete elimination of the drug packages.

摘要

毒品的贩运和销售常常涉及大量毒品的腹内运输,通常是可卡因或海洛因(“人体包裹”),或者在有被捕风险时,口服少量用于立即转售的毒品(“人体填塞”)。本研究旨在描述在12年期间,当局转介到我们急诊科的132例人体包裹(n = 36)、人体填塞(n = 83)或混合病例(n = 13)的特征、并发症及医疗随访情况。对这132例病例的分析未发现任何腹内包装破裂或渗漏,也未发现任何急性中毒病例。然而,3例人体包裹者(2.3%)因胃内包装滞留需要进行手术干预。诊断时包裹位于胃内的患者平均住院时间比包裹位于胃肠道较低部位的患者长(分别为61.9小时和43.8小时),但差异无统计学意义(p = 0.13)。住院时间与(非特异性)症状的存在或摄入包裹的总数无关。总之,对这132例人体包裹者和人体填塞者的研究使我们能够指出,这些患者的医疗管理很少伴有严重并发症,并且他们的住院时间通常较长,在药物包裹完全排出之前平均为2天。

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