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目的探讨食管癌术后酒精戒断综合征的原因及有效预防治疗措施。方法 2000年1月-2011年10月共行食管癌手术935例,术后发生酒精戒断综合征16例,患者均为男性,年龄41～67岁,平均54岁。饮酒史16～47年,平均27.8年;每日饮白酒量为250～1 000 g,酒精含量162～590 g,平均321.5 g。所有患者均符合中国精神疾病分类与诊断标准第3版(CCMD-3)酒精戒断综合征诊断标准。在食管癌常规术后治疗的基础上,根据患者谵妄、烦躁、精神失常、昏迷等不同情况应用维生素B族、纳络酮、氟哌啶醇、氯丙嗪、安定、促进脑细胞代谢及补充能量等综合治疗,必要时予以镇静后气管插管呼吸机辅助呼吸。结果患者经治疗后戒断症状均完全消失,治疗时间2～10 d,平均5.3 d。13例获随访,随访时间4～18个月,均完全戒酒,其中1例术后8个月死于急性心肌梗死;余12例均恢复良好,且未出现酒精戒断症状。结论经合理有效的围手术期处理,食管癌术后酒精戒断综合征发生率可明显降低,详细询问病史,术前术后积极预防并及时给予有效的治疗是治愈的关键。
Objective To investigate the causes of postoperative alcohol withdrawal syndrome in esophageal cancer and effective prevention and treatment measures. Methods From January 2000 to October 2011, 935 cases of esophageal cancer surgery were performed. 16 cases of alcohol withdrawal syndrome occurred after surgery. The patients were all male, aged 41 to 67 years old, with an average age of 54 years. The history of drinking was 16-47 years, with an average of 27.8 years. The daily drinking amount of liquor was 250-1 000 g, and the alcohol content was 162-590 g, with an average of 321.5 g. All patients met the diagnostic criteria of the Chinese Mental Disorder Classification and Diagnosis Standard 3rd edition (CCMD-3) for alcohol withdrawal syndrome. On the basis of conventional postoperative treatment of esophageal cancer, Vitamin B, naloxone, haloperidol, chlorpromazine, and diazepam are used to promote brain cell metabolism and supplementation according to different conditions such as patient irritability, irritability, mental disorders, and coma. Comprehensive treatment such as energy, if necessary sedated, intubation, intubation, ventilator assisted breathing. Results The symptoms of withdrawal were completely disappeared after treatment. The treatment time was 2 to 10 days, with an average of 5.3 days. Thirteen patients were followed up for 4 to 18 months. All patients were completely abstinent alcohol. One patient died of acute myocardial infarction 8 months after surgery. The remaining 12 patients recovered well and no alcohol withdrawal symptoms occurred. Conclusions After a reasonable and effective perioperative management, the incidence of alcohol withdrawal syndrome after esophageal cancer surgery can be significantly reduced. Detailed medical history, active prevention and timely and effective treatment before and after surgery are the key to cure.