Yost D A
U.S. Public Health Service, Whiteriver, Arizona, USA.
Am Fam Physician. 1996 Aug;54(2):657-64, 669.
Hundreds of thousands of significant alcohol withdrawal episodes are encountered by primary care physicians every year. If the situation is appreciated at an early stage, most patients can be managed successfully on an outpatient basis with benzodiazepines. Patients with seizures, concurrent medical illnesses and severe withdrawal signs should be hospitalized. Fewer than 5 percent of patients withdrawing from alcohol progress to delirium tremens. Mortality from delirium tremens has been reduced to less than 5 percent of patients, through early diagnosis, supportive nursing care, treatment of coexisting medical conditions and aggressive pharmacologic therapy. Patients with a history of multiple detoxification episodes are more likely to experience seizures and severe withdrawal symptoms.
每年,初级保健医生会接诊数十万例严重的酒精戒断病例。如果能在早期识别这种情况,大多数患者可在门诊使用苯二氮䓬类药物成功治疗。有癫痫发作、并发内科疾病及严重戒断症状的患者应住院治疗。酒精戒断患者中进展为震颤谵妄的不到5%。通过早期诊断、支持性护理、治疗并存的内科疾病及积极的药物治疗,震颤谵妄的死亡率已降至患者总数的5%以下。有多次戒毒经历的患者更易出现癫痫发作和严重的戒断症状。