492例美沙酮维持治疗情况分析

目的:观察美沙酮维持治疗(methadone maintenance treatment,MMT)中药物剂量的使用和参加MMT治疗者的依从性。方法:对本门诊2006年9月28日-2007年3月8日累计收治的492例阿片类成瘾者的病历资料、治疗中药物剂量的使用、合并用药以及尿检抽查结果、脱失病例进行分析。结果:所有治疗者均符合MMT的收治条件。美沙酮平均首次用药的剂量是25.67mg±s10.22mg,维持阶段的适宜剂量是45.71mg±s21.76mg。治疗中有合并用药病例占调查总数的64.3%(270/420),合并用药以海洛因、镇静催眠药为主。治疗中脱失110例,脱失率占累计收治人数的22.4%。本文在用药前通过观察治疗者的瞳孔大小调整美沙酮剂量,避免了过量用药或用药不足,缩短了治疗周期,提高了治疗的安全性。结论:MMT适宜在医疗机构开展,维持剂量的使用应个体化。参加治疗者在治疗期间合并用药,偷吸毒品是影响MMT依从性、导致脱失的主要原因。

ANALYSIS OF 492 PATIENTS ON METHADONE MAINTENANCE TREATMENT

Objective:To observe the dose of methadone for and the compliance of patients to maintenance treatment(MMT). Methods:The clinical data, drug doses, combined use of drugs, urine test, methadone dropout data of 492 cases of heroin addicts who underwent MMT since Sept. 28, 2006 to Mar 8, 2007 in the Second Hospital of Beilin were analyzed. Results:All patients met the criteria of MMT. The initial dose of methadone was 25.67 mg±s 10.22 mg, the maintenance dose was 45.71 mg±s 21.76 mg. During the treatment, 64.3%(270/420) used other drugs , mainly heroin and sedatives and hypnotics; 110 dropped out, accounting for 22.4%. Methadone dose for the patients adjusted by observing the patients’ pupil sizes, which avoided overdose and insufficient dose, and reduced the treatment cycle and enhanced safety. Conclusion:MMT should be carried out in medical institutions. The maintenance dose should be individualized.