小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 戒断
- 耐受
- 肝脏体积增大/减小、黄疸、腹水
其他诊断因素
- 失眠
- 勃起功能障碍
- 尼古丁使用障碍
- 胃肠道不适
- 肌肉痉挛、疼痛、无力、感知觉改变
- 高血压和心动过速
- 营养状态受损
- 宽基步态
危险因素
- 酒精使用障碍家族史
- 反社会行为(病前)
- 高焦虑特质水平
- 饮酒后不脸红
- 对酒精影响的低反应性
- 胃旁路手术史
诊断性检查
首要检查
- 诊断性访谈
- 酒精含量(呼出的气体和血液)
- 临床酒精戒断状态评定量表修订版(CIWA-Ar)
需考虑的检查
- 缺糖基转铁蛋白 (CDT)
- γ-谷氨酰转肽酶、丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)
- 全血细胞计数 (FBC)
- 尿乙基葡萄糖醛酸苷
治疗流程
危险饮酒
酒精使用障碍:非妊娠成人,未同时使用阿片类药物,也未诊断有心理健康问题
酒精使用障碍:非妊娠成人,同时使用阿片类药物
酒精使用障碍:非妊娠成人,同时诊断有心理健康问题
酒精使用障碍:非妊娠青少年
酒精使用障碍:妊娠者
撰稿人
作者
Elisabeth Poorman, MD, MPH
Assistant Professor of Medicine
Department of Medicine
University of Illinois Chicago
Chicago
IL
利益声明
EP declares that she has no conflicting interests.
Marlene Martin, MD
Associate Professor of Clinical Medicine
Director, Addiction Care Team
San Francisco General Hospital
University of California, San Francisco
San Francisco
CA
利益声明
MM is a board member and Chair of Diversity for AMERSA and Chair of the SHM Substance Use Disorder Special Interest Group, and has received an honorarium from Elsevier.
Sarah Messmer, MD
Assistant Professor of Clinical Medicine and Pediatrics
University of Illinois Chicago
Chicago
IL
利益声明
SM declares that she has no conflicting interests.
鸣谢
Dr Elisabeth Poorman, Dr Marlene Martin, and Dr Sarah Messmer would like to gratefully acknowledge Dr Colin Drummond, Dr Julie R. Pittman, Dr Philip H. Chung, Dr Robert M. Swift, and Dr Lorenzo Leggio, previous contributors to this topic.
利益声明
CD, JRP, PHC, and RMS declare that they have no competing interests. LL is an author of a reference cited in this topic.
同行评议者
Paul S. Haber, MD
Royal Prince Alfred Hospital and Discipline of Medicine
University of Sydney
Sydney
Australia
利益声明
PSH is an author of a reference cited in this topic.
Roberta Agabio, MD
Bernard B. Brodie Department of Neuroscience
University of Cagliari
Cagliari
Italy
利益声明
RA is an author of a number of references cited in this topic.
内容使用需遵循免责声明