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门诊医学监督下的酒精戒断

Authors
Joseph R Volpicelli, MD, PhD
Scott A Teitelbaum, MD
Section Editor
Richard Saitz, MD, MPH, FACP, DFASAM
Deputy Editor
Richard Hermann, MD
Translators
李冰, 主任医师，副教授

引言

酒精脱瘾的目标有3方面：治疗酒精戒断的症状；预防严重事件(癫痫发作、震颤谵妄或死亡)；以及将患者过渡到维持长期康复的治疗。

《精神障碍诊断与统计手册(第Ⅳ版修订版)》(Diagnostic and Statistical Manual of Mental Disorders Ⅳ-text revision, DSM-Ⅳ-TR)中酒精滥用和酒精依赖这两个精神病学诊断，已被DSM-5中酒精使用障碍这一诊断所取代[1]。虽然DSM-Ⅳ与DSM-5的障碍并不完全对应，但酒精依赖大约等同于酒精使用障碍的中度至重度亚型，而酒精滥用与酒精使用障碍的轻度亚型相似。

酒精使用障碍患者可获益于有组织的干预以减少饮酒和/或实现并维持戒瘾。多数中度至重度酒精使用障碍患者在生理上依赖酒精，将首先需要医学监督下的酒精戒断[2,3]。

本文将总结门诊医学监督下的酒精戒断。更严重酒精戒断的非门诊治疗参见其他专题。酒精使用障碍的筛查与治疗也单独讨论。 (参见“中重度酒精戒断综合征的处理”和“酒精使用障碍的药物治疗”和“酒精使用障碍的心理社会治疗”和“酒精和其他药物不健康使用的筛查”和“Brief intervention for unhealthy alcohol and other drug use”)

戒断的病理生理学

长期使用酒精时突然减量会导致酒精戒断综合征。即使仅持续1周的过度饮酒也可导致轻度的戒断症状，持续1个月以上的过度饮酒可导致明显的戒断症状[4]。

                        

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Literature review current through: 2017-07 . | This topic last updated: 2015-01-12.
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