高校大学生急性酒精中毒发病规律及治疗体会

急性酒精中毒是指短时间内一次性大量饮入酒精或含有酒精的饮品,引起的中枢神经系统由兴奋转为抑制的状态[1].急性酒精中毒损害自身健康,可诱发多种严重疾病,如突发心脏病、脑血管意外、猝死等.相关研究证实,过量饮酒还会增加意外创伤、暴力、吸毒、交通事故的发生率[2].在美国,与死亡相关的可预防性因素中,酒精因素仅次于吸烟和肥胖,位列第3位;每年有近8 500人死于酒精,其中近50%死于酒精相关创伤[3].在我国,急性酒精中毒已成为各级医院急诊常见的病例.近几年,随着大学生饮酒人数的增加,因酒精中毒而引发的相关危害频繁发生,为此,笔者对东北林业大学急性酒精中毒患者资料进行收集和分析,结果报道如下.     

有害使用酒精对健康的危害

正WHO定义有害使用酒精为"对饮酒者、饮酒者身边的人以及整个社会造成有害健康和社会后果的饮酒行为,也包括可能是使有害健康后果风险增加的饮酒模式。它危及到个人与社会的发展,可能毁掉个人生活、破坏家庭并损害社区结构"~([1])。有害使用酒精与200多种疾病的发生有关,包括酒精使用障碍、肝硬化、心血管疾病、癌症等非传染性疾病,艾滋病、结核病等传染病,有害饮酒还可能造成家庭暴力行为和交通事故。     

少饮酒，不酗酒

白酒基本上是纯能量食物，不含其他营养素。经常过量饮酒，会使食欲下降，食物摄人量减少，从而导致多种营养素缺乏、急慢性酒精中毒、酒精性脂肪肝等，严重时还会造成酒精性肝硬化。过量饮酒还会增加患高血压、脑卒中（中风）等疾病的风险，并可导致交通事故及暴力事件的增加，对个人健康和社会安定都是有害的。应该严禁酗酒。尽可能饮用低度酒，建议成年男性一天饮用酒的酒精量不超过25g，成年女性不超过15g。孕妇和儿童、青少年不应饮酒。     

酒精性肝病诊治“三个三”

酒精进入人体后在肝脏内进行代谢，24小时内可代谢120克酒精。因此，当少量饮酒肝脏能够完全代谢．不会对肝脏产生不利影响。但若长期或大量饮酒，一旦超过肝脏对酒精的代谢能力，就会造成肝脏病变．包括肝细胞发生脂肪变性、坏死和再生等。据报道，1O％～20％的酗酒者都有不同程度的酒精性肝病。     

深圳市居民饮酒现况及影响因素分析

目的了解深圳市居民饮酒现况及相关影响因素,为健康教育和干预策略提供依据。方法采用多阶段随机整群抽样,在深圳市的8个区中抽取2442名居民进行饮酒相关问卷调查。结果本次调查对象现在饮酒率为19.2%（469人）,男性饮酒率（32.3%）高于女性（8.1%）（P〈0.001）;平均酒精摄入量为4.75g/d,60岁以上人群酒精摄入量最高,为7.34 g/d;平均饮酒频次为0.95次/周,45~59岁年龄段的人饮酒频次最高,为1.15次/周。多因素Logistic分析结果显示性别、年龄、婚姻状况均为影响饮酒的因素。结论不同特征人群饮酒率存在差异,对重点人群进行有针对性的干预,将有助于控制居民饮酒率。     

肝硬化病人八忌

忌酒烟 酒精对肝细胞有直接毒性作用。长期饮酒可导致酒精性肝炎甚至酒精性肝硬化。饮酒还会引起上腹部不适、食欲减退和蛋白质与维生素缺乏。尼古丁有收缩血管作用，长期吸烟可造成肝脏供血减少，不利于肝病稳定。     

医学快讯

酒精助长吸烟之害 吸烟可致肺癌,人所共知。然而,何以有那么多的吸烟者竟能幸免于患上肺癌? 新近发表的研究报告指出,酒精可能助长吸烟之害。既吸烟又经常饮酒的人,其体内发生某种基因突变而引致肺癌的机率,比不饮酒的吸烟者高出将近一倍。 人体原本有能力将吸烟所得致癌物质的毒性减弱、甚至消除,而酒精或许会削弱这种能力。人体本来也有能力把某些被致癌物质损伤的DNA修复,但这种能 力也可能为酒精所破坏。     

男性“性福”生活的常见误区

正饮酒助"性"幸福难长在各类影视剧中,我们常常可以看到男女酒后性爱的镜头。很多人纷纷效仿,喜欢依靠饮酒助"性"。的确,酒精对人的中枢神经和性神经都有一定的兴奋作用,少量饮酒有助于促进性欲和性兴奋。但如果经常依靠饮酒来刺激性欲的话,会对人的身体造成严重伤害。人们在性生活之前饮酒过多,血液中的酒精浓度会很快达     

酒精戒断综合征

酒精戒断综合征（AWS）为酒精依赖者在其本次饮酒后6～24h内产生的一系列典型的症候群。此病通常发生于因其他疾病而强行戒酒，或由于发生与酒精有关的其他疾病而自愿放弃饮酒的患者中。AWS的症状和体征比较多，如焦虑、颤抖、心动过速、厌食、恶心、反射亢进、失眠、恶梦、出汗、高热、走向力障碍、高热、癫痫发作、谵妄等。该病在西方居民中极为常见，据调查：美国具有酒精滥用史或产生酒精依赖性者占14％，而且这部分人有一半伴有酒精戒断症状。多数情况下酒精戒断症状不需要药物治疗，而且在停止饮酒后2～7d内症状会自然消失，但对于…     

健康老年人群的酒精摄入量

前言人们对长期大量酒精摄入的危险已揭示得很充分,但对适量饮酒的作用尚有争议。几个研究小组提出,甚至小剂量酒精摄入也会对认识功能产生明显的永久性的损伤。对这种结论有人已提出质疑。老年人是那些研究有关酒精问题的专家们所格外感兴趣的一个人群。肝脏代谢功能降低、疾病和用药增加、社会赞助减少等情况,常常是伴随身体老化而出现,而且易使人罹患与酒精有关的各种疾病。最近一项调查认为老年人摄入酒精是有害的,并且推断甚至有节制的社交饮酒也会损伤认识能力。一部主要的老年病学教科书里关于酒精的章节中写道:“经常饮酒的老年人,其抽象能     

Mad drivers: psychiatric illness and driving performance

Road traffic accidents are a leading cause of mortality and morbidity. It has been estimated that over 25% of drivers involved in accidents had impaired driving due to alcohol, drugs, illness or emotional distress. This paper reviews the association between road traffic accidents and psychiatric illness including the effects of alcohol, drugs and psychotropic medication.     

Blood alcohol concentration in fatal traffic accidents in the Federal District, Brazil

The objective of the study was to assess the association between high blood alcohol levels and fatal victims of traffic accidents in the Brazilian Federal District, in 2005. A total of 442 casualties (163 pedestrians, 84 victims of overturns, and 195 of collisions) were studied. Blood alcohol concentration was analyzed in 238 cases (53.7%). Most victims were young males, aged between 18 and 35 years. Blood alcohol levels higher than 0.6 g/L were detected in 44.2% of collision victims; 57.7% of victims of overturns and 32.5% of pedestrians. The difference in proportions between overturn victims with blood alcohol concentration higher than 0.6 g/L and those victims of other traffic accidents was statistically significant.     

Present status of traffic accidents in the age of speed: an overview

This article takes an interdisciplinary perspective to studies on traffic accidents on a national and international scale. It begins by analyzing the great increase in the manufacturing and use of motor vehicles worldwide and the resulting social transformations. Particular attention is given to the degradation of the urban environment and the enormous social costs represented by traffic accidents. The author follows with an epidemiological perspective on the victims of traffic accidents. The relationship between personality and traffic accidents deserved special attention, mainly in that it relates to the consumption of alcohol and other drugs, in addition to other law breaking behavior. The article concludes by emphasizing the need for government to implement specifically consistent public policies to control the problem.     

驾驶员车祸危险因素的Logistic回归分析

本文对１１３名参加１９９３年上海市全市驾驶员体检的司机进行了随访。随访结果经单因素和多因素Ｌｏｇｉｓｔｉｃ回归分析初步显示，除驾驶车型外，男性、正中神经传导速度慢、驾龄短和饮酒为驾驶员车祸危险因素。据此提示，饮酒、驾龄短的司机为车祸易发人群，须加强对该亚人群的管理，以减少车祸的发生。     

Restricting access to alcohol and public health: Evidence from electoral dry laws in Brazil

We analyze the impact of short‐term alcohol bans on road traffic accidents, traffic injuries, and hospital admissions. We focus on the 2012 Municipal Elections in Brazil, during which 11 out of 27 states imposed on its 2,733 municipalities the decision to adopt alcohol bans. Using day‐level data on municipalities, we find that alcohol bans caused substantial reductions in road crashes (19%), traffic injuries (43%), and traffic‐related hospitalizations (17%). An analysis of traffic‐related hospitalization costs allows us to estimate the lower bound of the negative externality associated with excessive alcohol consumption in this context, which reveals that electoral dry laws saved Brazil's public healthcare system $100,000 per day.     

Breath alcohol test in construction sites in the Province of Belluno: a campaign in favour of health promotion and surveillance and against drinking

BACKGROUND AND OBJECTIVES: Health impairment due to alcohol use and abuse is well known, in terms of relationship with traffic accidents and work accidents. In Italy almost 10 per cent of accidents at work involve intoxicated people injuring themselves and innocent victims. Alcohol abuse is a factor involved in determining severe accidents in the construction industry and epidemiological studies demonstrated a relationship between an elevated alcohol use and severity of accidents. Since in the Province of Belluno alcohol consumption may be elevated also at work, the two Occupational Health Units (SPISAL) in the province organized a campaign of information and surveillance against alcohol consumption at work in the construction industry. This report shows the campaign results, mainly in terms of breath alcohol tests performed in construction workers. DISCUSSION AND CONCLUSIONS: After an extensive information campaign we inspected 50 sites, where 105 construction companies were at work, and tested 294 workers by breath alcohol test. No-one refused the test. Only 2.7% construction workers were positive for the breath alcohol test, and the levels were not elevated. This study shows that the construction workers in Belluno Province are responsible drinkers and are well aware of the policy of prohibition of alcohol consumption at work.     

酗酒——伤害发生重要而共同的危险因素

目的 分析饮酒对伤害发生的影响及立论饮酒是伤害共同危险因素，提出防治措施。方法 分别就酒精对大脑／肝脏的短期／长期作用，对机动车驾驶员／步行和骑自行车的影响，酗酒对意外伤害／故意伤害的影响进行比较研究、原因深入研究，就血酒浓度的增高对道路交通伤害的影响进行回顾分析。结果 酒精对大脑的短期作用与伤害发生关系密切，酒后驾车及酗酒后的步行、骑自行车，发生道路交通伤害的危险性增加。急诊伤害的前3位原因构成是机械伤、跌伤、道路交通伤害，并未因经济发达程度不同、地理位置不同而改变。酗酒是道路交通伤害、跌伤等意外伤害以及机械伤等故意伤害的危险因素。结论 酗酒是伤害发生重要而共同的危险因素；应加强健康教育、增强自控能力、健全法制法规、提高管理效能。     

Risk for injuries in traffic accidents among drivers under the effect of alcohol in Navarra]

We conducted a retrospective analysis of the levels of alcohol in the blood of a group of 54 drivers who required hospital emergency care after having suffered a traffic accident on roads in the Health Area III of Navarra (Spain) from June to September 1989, and compared them to another group of 219 drivers, not victims of traffic accidents, submitted to the breathalyser (test of alcoholaemia) on the roads of the same Health Area over the same period of time. In the group of 54 accident victims, the median alcoholaemia was 100 mg/dl, with a quartile deviation of 88 mg/dl, and the percentage of positives (alcoholaemia equal to or greater than 80 mg/dl) was 50.9%. In the group of 219 drivers not victims of traffic accidents, the median alcoholaemia was 16 mg/dl, the quartile deviation 18.5 mg/dl and the percentage of positive alcoholaemia was 1.8%. Drivers with a level of blood alcohol equal to or greater than 80 mg/dl have an estimated risk (Odds Ratio) of being injured in a traffic accident 55.82 times higher than drivers with a lower level.     

海宁市道路交通事故原因与疾病负担评价

目的探讨道路交通伤亡事故（简称车祸）原因与疾病负担。方法应用2001年全市车祸现场勘察信息及其相关资料，对车祸的成因、流行特征、人体损伤部位、经济损失情况等进行综合分析研究，并计算平均潜在寿命损失年（YPLL）、潜在工作寿命损失年（WYPLL）和潜在价值寿命损失年（VYPLL）在全死因中的位次。结果2001年海宁市人口车祸发生率188．59／10万、人口死亡率22．48／10万；万车事故发生率151．73、万车死亡率18．10。事故原因分析显示：人的因素占93．1％、其中驾驶员因素占89．4％，主要表现在：不按规定让行、措施不当、疏忽大意、纵向间距不够、违章行驶等；直接经济损失3127万元，平均每宗交通事故2．59万元，车祸导致的人均YPLL、WYPLL、VYPLL位居各类主要死因之首。结论提高驾驶员的综合素质，是预防车祸发生的关键。     

Impact of a drink-driving detection program to prevent traffic accidents (Villa Clara Province, Cuba)

OBJECTIVE: To determine the effectiveness of a method to reduce road traffic accidents and their consequences in the province of Villa Clara (Cuba). DESIGN: From May to October 2003, active surveillance of drink-driving was carried out. Analysis of chronological series was used. RESULTS: A total of 805 (12.46%) drivers were found to be under the effect of alcohol. Traffic accidents, deaths, and injuries decreased by 29.9%, 70.8% and 58.7%, respectively, in comparison with a similar period in 2002. The number of accidents in May, June, July, September and October fell below the historical low. The number of deaths was lowest in May, August and September. The number of injuries in July fell below the historical low. CONCLUSION: The interventions carried out proved useful in preventing traffic accidents and their consequences.