Breitenfeld D, Trkanjec Z, Thaller V, Breitenfeld T, DeSyo D, Golik-Gruber V
University Hospital Sestre milosrdnice, Zagreb.
Coll Antropol. 1998 Dec;22 Suppl:217-22.
Alcoholism and tuberculosis represent very difficult problem in treatment because both illnesses require complex treatment which cannot be adequately obtained on classic wards. Tuberculosis in the last 50 years showed the constant decline of incidence--in Croatia (4,500,000 inhabitants) from approximately 20,000 to approximately 2000 cases per year. This study compares preliminary results of AUDIT (Alcohol Use Disorders Identification Test) in the group of tuberculosis patients with the diagnosis of alcoholism (group 1) and in the group of tuberculosis patients who had not the diagnosis of alcoholism (group 2) and who all were admitted to the Hospital for pulmonary diseases and tuberculosis Klenovnik where is an organised unique ward management for tuberculosis and alcoholic patients functioning for the last 25 years on the basic principles of therapeutic community. Their average AUDIT score was 25.44--very high, and all patients scored above 8, what indicated on harmful and hazardous drinking. Additionally, in the group of patients admitted for hospital treatment of tuberculosis without diagnosis alcoholism there were more than 50% of harmful or hazardous alcohol drinkers who ranged 8 or more on AUDIT score, what could indicate that modern identification of hazardous drinking (for example using AUDIT) should be used in all pulmonary and tuberculosis wards. Patients for whom diagnostic procedure shows that they drink harmfully or hazardously should be treated simultaneously for tuberculosis and alcohol use disorders. Because of hidden alcohol problems the group sociotherapy should be organised for all patients at all wards for treatment of tuberculosis in a common and special alcohologic way.
酗酒和肺结核是治疗中非常棘手的问题,因为这两种疾病都需要复杂的治疗,而在传统病房无法充分实现。在过去50年里,肺结核发病率持续下降——在克罗地亚(450万居民),每年发病数从约2万例降至约2000例。本研究比较了诊断为酗酒的肺结核患者组(第1组)和未诊断为酗酒的肺结核患者组(第2组)的酒精使用障碍识别测试(AUDIT)初步结果,这些患者均入住克列诺夫尼克肺病和结核病医院,该医院有一个独特的病房管理体系,按照治疗社区的基本原则,为肺结核和酗酒患者提供治疗服务,已运行25年。他们的AUDIT平均得分为25.44——非常高,所有患者得分均高于8分,这表明存在有害和危险饮酒行为。此外,在未诊断出酗酒而入院治疗肺结核的患者组中,超过50%的患者存在有害或危险饮酒行为,其AUDIT得分在8分及以上,这可能表明所有肺病和结核病病房都应采用现代有害饮酒识别方法(如使用AUDIT)。诊断程序显示存在有害或危险饮酒行为的患者,应同时接受肺结核和酒精使用障碍的治疗。由于存在隐匿的酒精问题,所有病房的肺结核患者都应以常规和特殊的酒精治疗方式,组织团体社会治疗。