美沙酮维持治疗海洛因成瘾者352例临床分析

Application of methadone in maintenance treatment for heroin-addictive patients

目的:通过调查美沙酮维持治疗门诊治疗情况,了解目前社区美沙酮维持治疗存在的问题。方法:对2006年9月～2008年8月美沙酮维持治疗的门诊患者的药物滥用情况、临床观察及脱失情况进行调查分析。结果:352例患者丙肝发生率为41.48%,患者在治疗过程中存在睡眠障碍、胃纳差、肌肉抽搐、腹痛、便秘、小便困难以及依赖症状等不良反应;所有患者治疗剂量偏低,平均为38.22mL,每月尿检阳性率最高达37.84%,脱失率最高达70.45%。结论:美沙酮维持治疗减少了患者接触毒品的次数,且在医生的临床观察下逐渐调整美沙酮使用剂量,服药安全系数相对增高。但绝大多数的患者还是选择以小剂量维持,这就易造成在服用小剂量美沙酮的同时还在吸毒的现象,复吸率和脱失率均较高。

Objective：To investigate application and problem of methadone in maintenance treatment for heroin-addictive patients.Methods：Drug abuse status,clinic symptoms and loss situation of patients treated bymethadone were analyzed during Sep.2006 to Aug.2008.Results：Out of 352 patients,41.48% had hepatitis C patients with trouble in sleeping,poor appetite,muscle cramps,abdominal pain,constipation,urination problems and the dependent symptoms and so on.All patients had low dosage,averaged 38.22 mL,with monthly urine test positive rate as 37.84% and loss rate as 70.45%.Conclusions：Maintenance treatment with methadone can reduce frequency of access to drugs.The dosage is adjusted under clinical monitoring,and the safty factor is relative high.But the majority of patients prefer to maintain at small dose,which resultes in drug abuse,high relapse rate and loss rate.