检查患者的酒精使用情况是为了筛查有问题的饮酒者,预防酒精滥用以及相关的医学并发症。
检查工具
CAGE 问卷用于识别有酒精中毒/酒精依赖的患者。在识别酒精中毒方面,它的敏感性为 91%,特异性为 77%。[61]Williams N. The CAGE questionnaire. Occup Med (Lond). 2014;64:473-474.https://academic.oup.com/occmed/article/64/6/473/1432970/The-CAGE-questionnairehttp://www.ncbi.nlm.nih.gov/pubmed/25146056?tool=bestpractice.com[62]Bernadt MW, Mumford J, Taylor C, et al. Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet. 1982;1:325-328.http://www.ncbi.nlm.nih.gov/pubmed/6120322?tool=bestpractice.comCAGE questionnaire
在识别有危险的饮酒行为方面,酒精使用障碍识别测试 (Alcohol Use Disorders Identification Test, AUDIT) 和快速酒精筛查工具 (Fast Alcohol Screening Tool, FAST) 的效果优于 CAGE 问卷。[61]Williams N. The CAGE questionnaire. Occup Med (Lond). 2014;64:473-474.https://academic.oup.com/occmed/article/64/6/473/1432970/The-CAGE-questionnairehttp://www.ncbi.nlm.nih.gov/pubmed/25146056?tool=bestpractice.com[63]Kelly TM, Donovan JE, Chung T, et al. Alcohol use disorders among emergency department-treated older adolescents: a new brief screen (RUFT-Cut) using the AUDIT, CAGE, CRAFFT, and RAPS-QF. Alcohol Clin Exp Res. 2004;28:746-753.http://www.ncbi.nlm.nih.gov/pubmed/15166649?tool=bestpractice.comAlcohol Use Disorders Identification Test (AUDIT)Fast Alcohol Screening Test (FAST)
由于资源有限和/或缺少时间,在繁忙的临床环境中可能难以进行酒精筛查。简单的筛查工具可以在 12 至 14 秒钟内使用,例如 CAGE 和 FAST(4 个问题),而使用 AUDIT(10 个问题)需要长达 78 秒。[61]Williams N. The CAGE questionnaire. Occup Med (Lond). 2014;64:473-474.https://academic.oup.com/occmed/article/64/6/473/1432970/The-CAGE-questionnairehttp://www.ncbi.nlm.nih.gov/pubmed/25146056?tool=bestpractice.com[64]Williams N. The FAST questionnaire. Occup Med (Lond). 2014;64:559-560.https://academic.oup.com/occmed/article/64/7/559/1367378/The-FAST-questionnairehttp://www.ncbi.nlm.nih.gov/pubmed/25281578?tool=bestpractice.com因此,选择合适的筛查工具在临床上使用很重要。
酒依赖严重程度问卷和Leeds依赖问卷是正式的评价依赖严重程度的工具。[65]Raistrick D, Bradshaw J, Tober G, et al. Development of the Leeds Dependence Questionnaire (LDQ): a questionnaire to measure alcohol and opiate dependence in the context of a treatment evaluation package. Addiction. 1994;89:563-572.http://www.ncbi.nlm.nih.gov/pubmed/8044122?tool=bestpractice.com[66]Stockwell T, Hodgson R, Edwards G, et al. The development of a questionnaire to measure severity of alcohol dependence. Br J Addict Alcohol Other Drugs. 1979;74:79-87.http://www.ncbi.nlm.nih.gov/pubmed/283831?tool=bestpractice.com