海洛因依赖者脱毒期间发生急性胃穿孔的特点与防治

目的··:总结海洛因依赖者在脱毒过程中发生急性胃穿孔的发病原因、临床特点和防治方法。方法··:对我所1997年1月 -1999年3月收治的32例海洛因依赖者并发急性胃穿孔的临床资料进行回顾性分析 ;结果··:32例患急性胃穿孔的海洛因依赖者中 ,男性31例 ,(占96.8 %),女性1例 (占3.1 % );采用自然戒断法 (冷火鸡法 )脱毒者27例(占84.3 %);既往有胃病史者25例(占78.1 %);脱毒1周内发病者31例(占96.8 %);日滥用量>0.6g发病者28例(占87.5 %) ;吸毒年限1.9 -3a发病者26例(占81.3 %);采用烫吸 +静脉注射 +肌肉注射吸毒方式发病者30例(占93.7 %)。结论··:既往有胃病史的男性海洛因依赖者 ,采用自然戒断脱毒法的1周内最容易发生急性胃穿孔 ;急性胃穿孔的发生与海洛因滥用量、吸毒时间和吸毒方式有一定的关系 ;建议对上述患者应采用药物脱毒且适当延长脱毒时间

FEATURES AND PREVENTION OF ACUTE GASTRIC PERFORATION OCCURRING DURING DETOXIFICATION

Objective: To study the features of acute gastric perforation occurring during drug detoxification and methods of prevention. Method: Clinical records of heroin addicts who took detoxification from January 1997 to March 1999 in the Detoxification Institute were reviewed and the cases (32) who suffered from acute gastric perforation during this period were analyzed. Result: Among the 32 cases, 31(96.8%) were male; 27(84.3%) had detoxification without pharmaceutical treatment (cold turkey); 25(78.1%) were found to have a history of gastric disease; 31(96.8%) suffered from acute gastric perforation during the first week of detoxification; 28(87.5%) abused heroin more than 0.6 g·d-1; 26(81.3%) had a drug abuse history of 1.9-3 years; 30(93.7%) abused drugs with mixed routes: snorting, im and iv. Conclusion: Male with a history of gastric disease, undertaking detoxification without pharmaceutical treatment would likely suffer from acute gastric perforation within one week after entering detoxification institutions. Occurrence of acute gastric perforation is related with the amount, duration and routes of their heroin abuse. It is suggested that pharmaceutical therapy be adopted for detoxification and the treatment duration be prolonged.