A case report of an alcoholic with delirium tremens diagnosed with hypopharyngeal cancer: Psychiatrists played important roles in the smooth diagnosis and treatments
A case report of an alcoholic with delirium tremens diagnosed with hypopharyngeal cancer: Psychiatrists played important roles in the smooth diagnosis and treatments
复制标题
酒鬼震颤性谵妄确诊下咽癌一例：诊断和治疗顺利，精神科医生发挥了重要作用
DOI：
10.1002/pcn5.54
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Kobayashi Seiju
中科院分区：
文献类型：
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作者：
Ishida Tetsuro;Murayama Tomonori;Kobayashi Seiju
背景饮酒会增加患多种癌症的风险。其中，下咽癌的预后最差之一。此外，治疗患有下咽癌的酗酒患者通常很困难。下咽癌有多种治疗方法，包括手术、化疗和放疗，具体取决于癌症的状态和患者的生活质量。患者在决策和治疗后随访中需要身体、心理和社会支持。对于酗酒的患者尤其如此。 病例介绍一名 59 岁男性因疲劳、食欲不振和上肢震颤入院。他单身、酗酒、没有家人。治疗震颤性谵妄后，他抱怨喉咙疼痛。经过内窥镜、磁共振成像和18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描检查，他被诊断为4 A期（T2 N2c M0）下咽癌。精神科医生和耳鼻喉科医生讨论了患者的决策能力以及与治疗相关的各种风险。在确定治疗策略时，与患者共同决策被认为是最重要的。因此，患者决定接受内镜喉咽手术联合淋巴结清扫术，这是一种具有挑战性的手术治疗方法。手术很成功，患者现在已为出院后的新生活做好了准备。结论精神科医生在酗酒和其他精神疾病患者的肿瘤治疗中可以发挥重要作用。
BackgroundAlcohol use increases the risk of developing several types of cancer. Of these, hypopharyngeal cancer has one of the worst prognoses. Moreover, treating an alcoholic patient with hypopharyngeal cancer is often difficult. There are various treatments for hypopharyngeal cancer, including surgery, chemotherapy, and radiotherapy, depending on the state of the cancer and the patient's quality of life. Patients need physical, psychological, and social support in decision‐making and post‐treatment follow‐up. This is especially true for alcoholic patients.Case PresentationA 59‐year‐old man was admitted to our hospital with complaints of fatigue, loss of appetite, and tremor of the upper limbs. He was single, alcoholic, and had no family. After treatment for delirium tremens, he complained of throat pain. After endoscopy, magnetic resonance imaging, and examination with 18F‐fluorodeoxyglucose positron emission tomography/computed tomography, he was diagnosed with Stage 4 A (T2 N2c M0) hypopharyngeal cancer. The psychiatrist and otolaryngologist discussed the patient's decision‐making capacity and the various risks associated with treatment. Shared decision‐making with the patient was considered most important in determining the treatment strategy. As a result, the patient decided to receive endoscopic laryngopharyngeal surgery in combination with lymphadenectomy, a challenging surgical treatment. The operation was successful, and the patient is now ready for a new life after discharge.ConclusionPsychiatrists have a significant role to play in the oncological treatment of patients with alcoholism and other psychiatric disorders.