对于任何有酒精依赖且在就诊前数小时或数日内停止或减少饮酒的患者，应怀疑急性酒精戒断或即将出现酒精戒断。[1]National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications. Apr 2017 [internet publication].
https://www.nice.org.uk/guidance/cg100
[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
[3]Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, vol 1. Oxford, UK: Blackwell publishing; 2011:429-36.
https://www.eaneurology.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2011_Alcohol-related_seizures.pdf
常见症状包括焦虑、恶心或呕吐、自主神经功能障碍和失眠。[1]National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications. Apr 2017 [internet publication].
https://www.nice.org.uk/guidance/cg100
[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
[3]Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, vol 1. Oxford, UK: Blackwell publishing; 2011:429-36.
https://www.eaneurology.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2011_Alcohol-related_seizures.pdf
这些症状可进展至重度戒断性癫痫发作和酒精戒断性谵妄。[1]National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications. Apr 2017 [internet publication].
https://www.nice.org.uk/guidance/cg100
[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
[3]Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, vol 1. Oxford, UK: Blackwell publishing; 2011:429-36.
https://www.eaneurology.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2011_Alcohol-related_seizures.pdf
尽早识别出现重度酒精戒断特征的患者。这些患者需紧急治疗。寻求上级医生和危重症诊疗支持。酒精戒断性谵妄是一种致死性医学急症，需要使用苯二氮卓类药物进行紧急治疗。癫痫发作患者也需紧急接受苯二氮卓类药物治疗，以减低进一步癫痫发作可能性。
并非所有出现酒精戒断症状的患者都需要紧急药物治疗；对于出现轻中度酒精戒断症状的患者，一般只需予以支持性治疗进行病情管理。[3]Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, vol 1. Oxford, UK: Blackwell publishing; 2011:429-36.
https://www.eaneurology.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2011_Alcohol-related_seizures.pdf
对任何需要急性药物治疗的患者，开始苯二氮卓类药物治疗方案（根据临床情况确定使用固定剂量方案或症状触发治疗方案）。[1]National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications. Apr 2017 [internet publication].
https://www.nice.org.uk/guidance/cg100
[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
酒精戒断反应发生于存在酒精依赖并且在就诊前数小时或数日内已停止或减少酒精摄入的患者。[1]National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications. Apr 2017 [internet publication].
https://www.nice.org.uk/guidance/cg100
[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
[3]Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, vol 1. Oxford, UK: Blackwell publishing; 2011:429-36.
https://www.eaneurology.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2011_Alcohol-related_seizures.pdf
症状通常在患者末次饮酒后 6-12 小时出现，并且可进展为致死性酒精戒断性谵妄（也称为震颤性谵妄），伴或不伴癫痫发作。[2]Royal College of Physicians. Alcohol dependence and withdrawal in the acute hospital. June 2012 [internet publication].
https://www.rcplondon.ac.uk/guidelines-policy/alcohol-dependence-and-withdrawal-acute-hospital
[4]Bayard M, McIntyre J, Hill KR, et al. Alcohol withdrawal syndrome. Am Fam Physician. 2004 Mar 15;69(6):1443-50.
https://www.aafp.org/afp/2004/0315/p1443.html
http://www.ncbi.nlm.nih.gov/pubmed/15053409?tool=bestpractice.com
[5]Parker AJ, Marshall EJ, Ball DM. Diagnosis and management of alcohol use disorders. BMJ. 2008 Mar 1;336(7642):496-501.
http://www.ncbi.nlm.nih.gov/pubmed/18310004?tool=bestpractice.com
[6]Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90.
https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9781615371969
http://www.ncbi.nlm.nih.gov/pubmed/29301420?tool=bestpractice.com
[7]Hall W, Zador D. The alcohol withdrawal syndrome. Lancet. 1997 Jun 28;349(9069):1897-900.
http://www.ncbi.nlm.nih.gov/pubmed/9217770?tool=bestpractice.com
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