限酒的健康教育指导

饮酒在中国人的文化中占有重要的意义,且饮酒的弊端也众所周知。如何指导人们了解饮酒与健康的关系,引导高危人群有效控制饮酒量、改变其生活方式是临床健康教育的重要内容。本文阐述了饮酒的基本常识、不健康饮酒行为所导致的不良后果等。重点介绍了限酒指导的步骤,旨在为临床护士提供有效的健康教育指引,以帮助患者及高危人群减少饮酒引发的相关疾病。     

警惕酒瘾患者急性戒酒诱发酒精戒断综合征

目的 探讨有大量饮酒史患者因躯体疾病停酒后发生酒精戒断综合征的临床表现及最佳治疗方案.方法 对有大量饮酒史者因躯体疾病停酒后出现酒精戒断综合征56例的临床资料进行回顾性分析.结果 56例均长期大量饮酒,患躯体疾病时急性停酒发生震颤、谵妄、抽搐,严重者出现发热、出汗及冲动、攻击行为等酒精戒断综合征表现.入院后结合每个患者病前饮酒量及时间给予逐渐戒酒,治疗初日饮酒量为原饮酒量的2/3,后根据症状缓解情况调整饮酒量,同时治疗原发病,并根据精神症状短期应用抗精神病药物.所有患者症状皆持续1～4 d,夜间加重,症状缓解后有长时间深睡眠,醒后对事情无记忆或片段记忆.予饮酒治疗7～10 d停酒,均治愈酒精戒断综合征出院.结论 对有大量饮酒史患躯体疾病者除对症治疗躯体疾病外,应尽量避免急性停酒,预防出现酒精戒断综合征.     

限酒的健康教育指导

饮酒在中国人的文化中占有重要的意义,且饮酒的弊端也众所周知.如何指导人们了解饮酒与健康的关系,引导高危人群有效控制饮酒量、改变其生活方式是临床健康教育的重要内容.本文阐述了饮酒的基本常识、不健康饮酒行为所导致的不良后果等.重点介绍了限酒指导的步骤,旨在为临床护士提供有效的健康教育指引,以帮助患者及高危人群减少饮酒引发的相关疾病.     

国内五省市城乡社区抽样人群烟酒合用现况调查

目的:了解国内五地区城乡抽样人群的吸烟率、饮酒率及烟草酒精合用情况,探讨两者间的相关性。方法:调查于2001-09/10完成,以四川成都市、吉林延吉市、安徽阜阳市、山东省济南市和湖南衡阳市的市区及各自附近农村地区为调查框架区域。采用分层整群抽样方法,应用“社区普通人群一般饮酒情况及健康状况调查表”调查国内五地区15岁或以上在本地居住1年及以上的城乡常住人口25002人的吸烟饮酒情况,进行单因素分析及线性检验,调查对象均知情同意。以调查前1年内曾经饮酒1次或以上者(25mL以上)称为饮酒者(不计酒精度数),吸烟1次或以上者称为吸烟者(不计烟焦油含量)。结果:剔除填写资料不完整者10人,进入结果分析24992人。①单因素分析结果:饮酒者吸烟率高于非饮酒者犤52.3%,10.6%,(χ2=4615.70,P<0.01)犦;按性别分层后饮酒者吸烟率也高于非饮酒者犤52.3%,10.6%,(χ2=3074.09,P<0.01)犦。吸烟人群饮酒率显著高于非吸烟人群犤87.7%,43.4%(χ2=5207.40,P<0.01)犦。饮酒与吸烟的Spearman相关系数0.43,两者具有显著相关性(P<0.01)。饮酒者平均日吸烟量高于非饮酒者犤(15±8)支,(13±9)支,(Z=7.83,P<0.01)犦。②不同年饮酒量人群吸烟率的线性检验结果:吸烟率随年饮酒量增加而增加,特别在年饮酒0～4.0L者中吸烟率增加明显。结论:烟酒合用是常见的社会行为,饮酒人群中吸烟人口及烟草使用量增加。年饮酒0～4.0L人群为烟草使用的防治重点。     

1999～2008年四川大学华西医院内科住院患者疾病与饮酒相关性调查

目的了解1999～2008年四川大学华西医院内科住院患者疾病与饮酒相关性情况。方法采用回顾性分层随机抽样调查方法,按照ICD-10酒相关性疾病诊断标准,使用统一设计的调查表对四川大学华西医院1999～2008年消化内科、内分泌科、神经内科、心血管内科共计8000例患者进行调查。结果①有饮酒经历者和无饮酒经历者性别、民族、职业、婚姻状况比较差异具有统计学意义（P〈0.05）;②本研究调查的患者中有饮酒经历者2279人,占调查患者的28.49%;规律饮酒者932人,占有饮酒经历者的40.90%;有饮酒经历者吸烟的比例高于无饮酒经历者（P〈0.01）;③酒相关性疾病患者共1521例,其中所患疾病最多的是2型糖尿病,占有饮酒经历者人数的13.08%。结论酒相关性内科疾病在综合医院内科住院患者中占较高比例且涉及多器官、多系统,本次调查发现比例最高的是2型糖尿病。饮酒与否受性别、民族、职业、婚姻状况等因素影响且常合并吸烟而加重损害。应加大宣传教育力度,增强人们对饮酒的正确认识,尽量减少饮酒量和饮酒频率,从而减少酒相关性疾病的发生。     

酒精性肝病 90例临床分析

目的:分析酒精性肝病患者发病情况及临床特点。方法:根据门诊及住院患者的饮酒量、饮酒时间、临床表现、肝功能检查、影像学检查、相应并发症、治疗等临床资料,进行分析和讨论。结果:酒精性肝病发病有增多趋势,长期饮酒史和AST/ALT、GGT、TBiL对酒精性肝炎的诊断有重要意义。A/G比值随疾病进展而降低。慢性病毒性肝炎的饮酒者预后差,死亡的主要原因是肝硬化的晚期并发症。结论:酒精性肝病病情和预后与长期饮酒史(包括饮酒量、饮酒时间)有关。对于有饮酒嗜好的病人,应对其进行健康教育劝其戒酒,并定期监测AST/ALT、GGT、TBiL等生化指标,及早进行治疗,改善预后。     

克罗恩病患者吸烟饮酒现状的调查与分析

目的了解克罗恩病患者吸烟饮酒现状,为给予针对性的生活习惯指导和健康教育提供借鉴。方法采用便利抽样的方法,应用自行设计的炎症性肠病患者吸烟饮酒情况调查问卷对杭州、南京和广州三市多家医院的157例克罗恩病患者进行调查。结果克罗恩病患者确诊后吸烟率为14.01%,且均为男性,其中36.36%患者每日吸烟量大于10支,有超过半数的患者存在不同程度的被动吸烟情况。目前有36.36%的吸烟患者已经戒烟;克罗恩病患者确诊后饮酒率为7.64%,其中38.46%患者每日饮用两种类型酒,23.08%患者饮酒频率超过3次/周,还有部分患者每日饮酒量超过正常人群平均水平。目前,50.00%的饮酒患者已经戒酒。结论部分克罗恩病患者仍有吸烟和/或饮酒的生活习惯,在知晓其具体吸烟饮酒行为的基础上,通过评估其对烟酒与疾病关系的了解程度给予个体化的健康指导,强调戒烟和适度饮酒对疾病的重要性。     

云南省两民族地州住院酒精所致精神障碍病人临床资料分析

目的：了解不同民族自治州酒精所致精神障碍住院病人的相关资料。方法：收集两所医院6年所住院的酒所致障碍的病例，对饮酒情况。文化程度及民族进行对照分析。结果：两地州酒精所致精神障碍病人均以少数民族占很大比例。饮酒情况，文化程度两地州病人有所不同。结论：酒精所致精神障碍发生率以少数民族较高，而不同民族风俗习惯及文化程度对饮酒情况有影响。     

酒精对血脂影响的国内研究综述

随着我国人民生活水平的不断提高 ,酒的生产量和销售量明显增高。大量研究证明酒精对血脂是有一定影响的。现将有关资料综述如下。1 长期不同饮酒量对血脂的影响 yh从近 1 0年来国内研究酒精对血脂影响报的道来看 ,基本上将长期饮酒量的区分定在如下范围 :小量饮酒 0 5～ 1 5ｋｇ/月 ,中量饮酒 >1 5～ 3 0ｋｇ/月 ,大量饮酒 >3 0ｋｇ/月。研究结果各家报道不尽一致 ,但在研究方法上基本趋于一致。即采取抽样调查 ,设立饮酒组和非饮酒组 ,进行结果对照分析。1 1 小中量饮酒对ＨＤＬ—Ｃｈ的影响在报道上基本上一致。即饮酒组ＨＤＬ—Ｃ…     

饮酒对长期酗酒者MCA血流灌注影响的TCCD对照研究

目的　探讨饮酒对长期酗酒者脑血流灌注影响的规律。方法　应用经颅彩色多普勒 (TCCD) ,对 76例酗酒者 (实验组 )及 5 2例非酗酒者 (对照组 )分别在饮酒前、饮酒后 30 min、1h、 2 h测定脑血流动力学参数 :收缩期峰值流速 (Vp)、舒张末期流速 (Vd)、平均血流速度 (Vm)、搏动指数 (PI) ,并观察频谱形态。采用同一品牌和批号的市售白酒 ,饮酒量按纯酒精折算 (0 .6 5 g/kg) ,实验于晚餐前 2 h开始 ,2 0 min内饮入。结果　 (1)酗酒者饮酒前双侧大脑中动脉 (MCA)基础血流速度 (Vp、 Vd及 Vm)均较正常减低、搏动指数 (PI)增大(P分别 <0 .0 1或 <0 .0 5 ) ,以平均血流速度 (Vm )减低最明显。血流频谱形态圆钝 ,S1 、 S2 峰融合 ,S2 >S1 。酗酒者饮酒后 30 min血流动力学参数较饮酒前变化不明显 ,1h后血流速度较饮酒前增高 (P<0 .0 1或 <0 .0 5 ) ,饮酒后 2 h各血流动力学参数基本恢复到饮酒前状态 ;(2 )非酗酒者饮酒后 30 min脑血流速度明显增高 ,1h后达到高峰 ,2 h后基本恢复到饮酒前状态 ;饮酒后脑动脉血流频谱 S1 峰较饮酒前尖耸。结论　本研究显示 :是否长期酗酒脑血流灌注情况有所不同、对急性酒精干预的反应不同 ;揭示了长期酗酒者对脑血流灌注的损害 ,对慢性酒精中毒、酒精性脑病的早期诊断和防治提供一     

Reasons for Living and Alcohol Use Among College Students

Heavy alcohol consumption is prevalent on many college campuses and alcohol use has been linked to suicidal behavior. The present study examined reasons for living in 287 college students with varying levels of risk for alcohol-related problems. With the exception of the moral objections subscale of the Reasons for Living Inventory, significant relationships were not detected between alcohol use risk levels and reasons for living. The field is ripe for additional studies examining alcohol use and suicide in the college population, and results will likely lead to improved interventions to decrease the occurrence of suicidal behaviors.     

Alcohol Expectancies and Drinking Behavior in Adults with Social Anxiety Disorder and Dysthymia

Previous research has found a positive relationship between social anxiety disorder and alcoholism, and that certain alcohol outcome expectancies are related to drinking behaviors. The purpose of this study was to examine the relationship among drinking behaviors and alcohol expectancies in treatment-seeking individuals diagnosed with social anxiety disorder or dysthymia, as well as normal controls. No significant differences were found across the 3 groups in alcohol consumption. As expected, socially anxious participants had higher social assertiveness expectancies than both participants with dysthymia and normal controls. Participants with social anxiety disorder had greater tension reduction and global positive change expectancies than the normal controls, but did not differ from participants with dysthymia. Additionally, the increased social assertiveness, tension reduction, and positive change expectancies were found to predict amount of drinking per month for socially anxious participants. Implications for understanding the relationship between social anxiety disorder and alcoholism are discussed.     

Expecting That Alcohol Use Will Reduce Social Anxiety Moderates the Relation Between Social Anxiety and Alcohol Consumption

We examined the hypothesis that social anxiety and alcohol outcome expectancies interact in relating to the quantity and frequency of alcohol consumption. Two hundred twenty-nine undergraduates completed self-report questionnaires. The results showed situational specificity of alcohol expectancies. Expecting that alcohol would reduce anxiety in social situations moderated the relation between social anxiety and alcohol consumption; no such moderating effect was found for expectancy of general tension reduction. Among those who did not expect alcohol to reduce their anxiety in social situations, high-social-anxiety participants reported lower frequency and quantity of alcohol consumption than did low-social-anxiety individuals. High- and low-social-anxiety participants who expected alcohol to reduce their social anxiety did not differ in their alcohol consumption.     

Alcohol use and problems in daily and non-daily coffee drinking college females

Background: For more than a decade, a large proportion of research on caffeine use in college students has focused on energy drinks (ED), demonstrating an association between ED consumption and heavy/problem alcohol use. The present study examined the relationship between daily coffee (DC) consumption and varied measures of alcohol use and problems in a sample of college women. Methods: Participants were undergraduate females (N = 360) attending an urban university in 2001–02 and prior to the rise in ED popularity on college campuses. Analyses compared women who reported drinking coffee daily (DC; 16.9%), to women who did not (non-daily coffee [NDC]; 83.1%) on standardized measures of alcohol use and problems. Results: For both past month and year of drinking, DC women generally reported consuming more alcohol and were 2.1–2.6 times more likely to screen at risk for alcohol problems than their NDC counterparts. DC women were also more likely than NDC women to report problems related to drinking (e.g., experiencing blackouts, inability to stop drinking after they had started). Conclusions: Findings support potential benefits of health education and screening that goes beyond EDs, focusing on varied forms of caffeine consumption.     

All it takes is one: drinking games,prepartying, and negative drinking consequences among high school students

Abstract

Prepartying (i.e. drinking before a social event/gathering) and participation in drinking games are two high-risk drinking behaviors practiced by adolescents.?Engaging in both these drinking behaviors may contribute to a multiple risk paradigm, wherein the risk associated with one’s general drinking is combined with the additional risk of rapidly ingesting alcohol as a result of one or both these activities.?The present study examines this paradigm among high school students who reported alcohol use (N?=?240).?Controlling for age and typical alcohol consumption, results indicated that participation in prepartying or drinking games was associated with more negative alcohol-related outcomes than non-participation. However, participation in both risky behaviors, as opposed to one, did not give rise to negative additive effects. Thus, students who participate in just one of these activities warrant the same attention from health professionals and school personnel as those who participate in both.?Importantly, results also showed that students who reported drinking games participation and prepartying endorsed social and coping drinking motives just as frequently as students who only reported drinking games participation.?However, students who engaged in multiple high-risk drinking behaviors were more inclined to drink to enhance the intensity of the “high” associated with alcohol use.     

To drink or not to drink: The differential role of alcohol expectancies and drinking refusal self-efficacy in quantity and frequency of alcohol consumption

Structural equation modeling was used to examine the relationships between alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) beliefs on the one hand, and quantity and frequency aspects of alcohol consumption on the other, in a sample of 118 undergraduate students. Specific expectancies that alcohol increases assertiveness and that the subject would have poor control over drinking were directly related to the consumption of larger quantities of alcohol per drinking occasion. Drinking refusal self-efficacy was related inversely to frequency of drinking: Subjects with high opportunistic DRSE and high social pressure DRSE drank less frequently. Females drank less per drinking occasion, drank less frequently, had a lower expectancy that alcohol increases assertiveness, expected to have greater control over their drinking, and had higher opportunistic DRSE than did males. The findings indicate that AE and DRSE play different roles in influencing the frequency and quantity of alcohol consumption. The implication of these findings for future research is discussed.We would like to acknowledge the expert statistical assistance given by Dr. David Chant and the support given by Ms Gabrielle Crook in the preparation of this paper.     

Sudden Death Associated with Alcohol Consumption

Evaluation of a binge drinker who died suddenly after a weekend of heavy beer consumption, and had been resuscitated successfully, revealed no evidence of clinically detectable heart disease. Baseline electrophysiological testing was normal. Following intravenous ethanol infusion, paired ventricular extrastimuli from the right ventricle induced a rapid polymorphic ventricular tachycardia requiring cardioversion. Repeat electrophysiological testing 24 hours later without alcohol infusion was again normal. The patient was discharged on no medications and was instructed to refrain from drinking alcohol. Approximately 3 months later the patient died suddenly after heavy beer consumption. Alcohol should be considered in the evaluation of survivors of cardiac arrest and alcohol challenge may be useful in their evaluation.     

Alcohol age of initiation and long-term impact: a cross sectional survey of adults in England

Background: Worldwide alcohol consumption is involved in 2.5 million deaths annually. Worryingly, the age of alcohol initiation may be decreasing; evidence suggests an inverse correlation between initiation and prevalence of alcohol use. European data are limited.

Methods: Data are from a survey (n?=?2638) on alcohol consumption of ≥18?y in England. Univariate and multivariate associations are reported between demography, last year alcohol consumption, historic drinking including having regularly drank alcohol <18?y (drank at least monthly), and experience of at least one serious alcohol-related problem (self-defined).

Results: Lifetime alcohol consumption was reported by 93.2% of participants. Of these, 36.1% reported regular consumption <18?y; 18–30?y had a threefold greater odds of reporting alcohol consumption <18?y than 61–75?y. In total, 5.2% reported at least one serious alcohol-related problem; those who had regularly consumed alcohol <18?y had a twofold greater odds of reporting this than those who had not.

Conclusion: Our sample supports a potential increase in the proportion of those reporting underage alcohol initiation. As those who regularly consumed alcohol <18?y were at risk of experiencing alcohol-related problems, incidence of harm could increase over time as early initiators start to experience harms, supporting the need for interventions to delay alcohol consumption in underage groups.     

Alcohol as a Factor in 911 Calls in Denver

Background: Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. Objectives: The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol. The secondary objectives were to compare the characteristics of EMS calls and to estimate the associated costs. Methods: This was a prospective observational cohort study of EMS calls for adults from July 1, 2012, to June 30, 2014. Primary outcomes for the study were alcohol as a contributing factor to the EMS call and recent alcohol consumption by the patient receiving EMS services. Logistic regression was utilized to determine the associations between EMS call characteristics and the outcomes. Cost was estimated using historic data. Results: During the study period, 169,642 EMS calls were completed by the Denver Health Paramedic Division. Of these 71% were medical and 29% were trauma-related. The median age was 45 (interquartile range [IQR] 29–59) years, and 55% were male. 50,383 calls (30%) had alcohol consumption, and 49,165 (29%) had alcohol as a contributing factor. Alcohol related calls were associated with male sex, traumatic injuries including head trauma, emergent response, use of airway adjuncts, cardiac monitoring, glucose measurement, use of restraints, use of spinal precautions, and administration of medications for sedation. Estimated costs to the EMS system due to alcohol intoxication exceeded $14 million dollars over the study period and required in excess of 37 thousand hours of paramedic time. Conclusions: Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden.     

Predictors of Alcohol Misuse and Abuse in Older Women

PURPOSE: To determine the predictive ability of self-report questions, physical measures, and biomarkers to detect alcohol misuse and abuse among older women. DESIGN AND METHODS: Healthy women volunteers age 60 and older who fit selection criteria were enrolled. The 135 participants were divided into nondrinkers (ND; n = 63) and drinkers (D; n = 72) based on self-reports of quantity and frequency of standard drinks consumed per month. The mean ages for the groups were 69.2 (ND) and 69.6 (D). FINDINGS: The best predictor was a score >0 on the T-ACE, a four-item instrument to detect alcohol abuse. Other significant predictors were: (a) behaviors: smoking, mixing over-the-counter (OTC) drugs with alcohol, heavy coffee drinking, using alcohol to sleep, and less sleep latency; and (b) biomarkers: higher mean corpuscular volume (MCV), hemoglobin (Hgb), hematocrit (Hct), and high-density lipoprotein cholesterol (HDL). The heaviest drinker subgroup had more physical stigmata, including broken blood vessels in nose and larger liver spans. CONCLUSIONS: The "best predictor model" showed that older women who were at risk for alcohol misuse or abuse had T-ACE scores of 1 or higher, used two or more OTC drugs regularly, drank large amounts of coffee, used alcohol to fall asleep, and had less sleep latency. Because positive T-ACE scores have high sensitivity and specificity for alcohol abuse, scores of 1 or greater should be addressed in clinical settings, e.g., referrals for more definitive diagnoses and relevant treatment.