頁籤選單縮合
題 名 | 酒精戒斷譫妄症的危險因子=The Risk Factors for Alcohol Withdrawal Delirium |
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作 者 | 殷建智; 李添誠; 張鳳麟; | 書刊名 | 臺灣精神醫學 |
卷 期 | 11:4 1997.12[民86.12] |
頁 次 | 頁37-45 |
分類號 | 415.8752 |
關鍵詞 | 酒精成癮; 酒精戒斷譫妄症; 危險因子; Alcohol dependence; Alcohol withdrawal delirium; Risk factors; |
語 文 | 中文(Chinese) |
中文摘要 | 目的︰本研究旨在以酒精成癮而住院治療的個案,藉臨床相關因子的分析比較,以進一步探討酒精戒斷譫妄症的危險因子,使臨床醫師可以預測酒精戒斷譫妄的可能發生及提早治療。方法︰研究樣本採自民國84年1月至85年12月期間,在台南奇美醫院精神科因酒精成癮引發相關疾病而住院治療者,共137位,男133位,女4位;平均年齡為42.2歲。臨床有酒精戒斷譫妄症的39位(簡稱AWD組),非AWD組的98位,進一步分析兩組間各項因子。結果︰AWD組的年齡較大、每日喝酒量較多、酒精成癮期較長、合併有身體疾病、過去有酒精戒斷痙攣或譫妄病史、及實驗室血液檢查的鈣、鎂、鉀、血紅素、血小板值偏低等。AWD組多數在酒精戒斷後72小時內出現譫妄(92%),譫妄期間多數在72小時內結束(79%)。AWD組住院第一週內平均每日藥物的使用量也較高。以逐步對數複迴歸方式進一步分析則發現,臨床發生AWD的危險因子中,依序以過去有酒精戒斷譫妄病史、低血鎂、低血紅素、酒精成癮期較長及每日喝酒量較多等五項預測因子最為顯著。結論︰酒癮患者有酒精戒斷譫妄過去史、低血鎂、低血紅素、酒精成癮期較長及每日喝酒量較多等五項因子者,其發生酒精戒斷譫妄症機會最高,臨床上宜事先加以預防及治療。 |
英文摘要 | Objectives: The aim of this study is to identify clinical risk factors related to alcohol withdrawal delirium (AWD), so that future treatment can focus on patients most likely to benefit from aggressive therapy. Methods: The study subjects included 137 inpatients diagnosed with alcohol dependence admitted to Chi-Mei Foundation Hospital from January 1995 through December 1996. The mean age was 42.2 years, 97% of the patients were male. Thirty-nine patients (28%) developed AWD during hospitalization. Results: Bivariate analysis indicated that those who developed AWD were more likely to be aged, with larger daily amount of alcohol consumption, longer period of alcohol dependence, had concurrent medical illness, had a positive history of AWD, had a positive history of withdrawal seizure, used larger dosage of benzodiazepine during the first week of hospitalization, and had lower than recommented levels of calcium/ magnesium/ potassium/ hemoglobin/ platelets in the patient's blood examined at admission. Most (92%) AWD developed within 72 hours after abstinence. In 79% of the patients with AWD, the delirium subsided in three days. Stepwise logistic regression analyses revealed that the significant risk factors of developing AWD are in sequence. The sequence of risk factors includes: a history of AWD, hypomagnesium, lower levels of hemoglobin, longer period of alcohol dependence, larger daily amounts of alcohol consumption. Conclusion: The alcohol dependent inpatients who have these risk factors just stated in results are at higher risk of developing AWD. Our study will help clinicians identify and more effectively treat these patients. |
本系統中英文摘要資訊取自各篇刊載內容。