K他命濫用之泌尿道病變與腎損傷

Ketamine Abuse-Induced Uropathy and Kidney Injury

許文定(Wen-Ding Hsu) ； 姜至剛(Chih-Kang Chiang)

《內科學誌》 26卷1期 (2015/02) Pp. 30-34

https://doi.org/10.6314/JIMT.2015.26(1).04

摘要

K他命自1960年代發展出來後，在醫學上常用於動物與人類麻醉劑。因其容易產生解離式幻覺，近幾十年來，迅速地成為年輕藥物濫用者的偏愛。而K他命濫用者，會因K他命的副作用，導致膀胱功能異常，泌尿道病變與腎損傷，但實際的致病機轉並不清楚。病人經常以下泌尿道症狀表現，包含下腹痛、尿急、排尿困難、頻尿與明顯血尿。實驗室與影像醫學檢查，容易發現膀胱容量變小、膀胱壁增厚，腎水腫與腎損傷。停止K他命濫用是防止腎臟功能持續惡化與緩解泌尿道症狀的最佳治療。而多領域團隊的介入照護，對K他命濫用之泌尿道病變是重要的處理策略。

關鍵字

K他命 ； 下泌尿道症狀 ； 急性腎損傷

並列摘要

Ketamine has been applied for anesthetics both in veterinary and human medicine since 1960s. Because Ketamine can easily lead to dissociative illusion, it quickly becomes the commonly preference among young drug abusers in recent decades. Ketamine abusers frequently encounter bladder dysfunction, uropathy and kidney injury, which derived from the adverse effects of Ketamine with unknown mechanisms. The patients usually present lower urinary tract symptoms, including lower abdominal pain, urgency, dysuria, frequency and frank hematuria. Small bladder capacity, bladder wall thickening, hydronephrosis and renal tubulointerstitial injury are obviously detected by image, laboratory and pathological studies. Cessation of Ketamine abuse is the best way to prevent the progressive deterioration of renal function and treat the intractable urinary symptoms. Multi-disciplinary team approach is an important strategy to manage the Ketamine abuse-induced uropathy.

並列關鍵字

Ketamine ； Lower urinary tract symptoms ； LUTS ； Acute kidney injury