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目的探讨苯二氮受体拮抗剂——氟马西尼治疗昏迷的临床价值。方法随机将61例急性苯二氮革类药物(BZDs)中毒患者分为氟马西尼治疗组和对照组,其中对照组30例,用一般治疗和酌情加用呼吸兴奋剂、纳洛酮;治疗组31例,在对照组治疗基础上加用氟马西尼静脉注射。采用Glasgow-Pattoburgh评分量表和观察者对患者机敏力／镇静程度评判量表(OAA／S)进行疗效判断。结果31例BZDs中毒患者经氟马西尼治疗后,5、15、30、60、120和180 min Glasgow-Pattoburgh得分较治疗前分别增加了:2．1、5．2、7．3、8．1、8．4、7．3,与对照组各时段比较Glasgow-Pattoburgh得分分别增加了:1．8、4．4、6．4、6．7、6．7、5．4,差异均有统计学意义(P<0．01),以OAA／S比较两组疗效,治疗组治疗后平均得分增加2．0,与对照组比较差异也有统计学意义(P<0．01)。结论氟马西尼治疗急性BZDs中毒有明显的症状逆转作用,且无严重不良反应。
Objective To investigate the clinical value of benzodiazepine receptor antagonist flumazenil in treatment of coma. Methods Sixty - one patients with acute benzodiazepines (BZDs) poisoning were randomly divided into flumazenil treatment group and control group, of which 30 patients in control group were treated with usual treatment and if appropriate, respiratory stimulants and naloxone; Treatment group of 31 cases, in the control group based on the treatment plus flumazenil intravenous injection. The Glasgow-Pattoburgh score scale and observer’s assessment of patient’s sensitivity / sedation rating scale (OAA / S) were used to determine the efficacy. Results The Glasgow-Pattoburgh scores at 5, 15, 30, 60, 120 and 180 min after flumazenil treatment in 31 patients with BZDs poisoning increased respectively as compared with those before treatment: 2.1, 5.2, 7.3 and 8 .1,8.4,7.3, compared with the control group Glasgow-Pattoburgh scores were increased: 1.8,4.4,6.4,6.7,6.7,5.4 differences (P <0.01). Compared with OAA / S, the treatment group had an average score of 2.0 after treatment, which was also significantly different from that of the control group (P <0.01). Conclusion Flumazenil treatment of acute BZDs poisoning has obvious reversal of symptoms, and no serious adverse reactions.