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目的观察纳洛酮和苯二氮(艹卓)类受体拮抗剂——氟马西尼联用在抢救急性酒精安定混合中毒的疗效和安全性。方法将85例急性酒精安定混合中毒患者随机分成两组:N组,43例,采用纳络酮0.8～2mg加入5% GS 20ml静注,然后每隔10min重复0.4mg,直至清醒或总量达4 mg;NF组,42例,在纳络酮处理同时,应用氟马西尼0.3mg加入5%GS 20ml静注,如未转醒,每间隔1min重复0.1mg,直至苏醒或总量达2mg。分别记录两组治疗前后的SBP、HR、RR、GCS评分及患者清醒时间及症状消失时间。结果两组治疗后的SBP、HR、RR、GCS评分均较治疗前明显提高(P<0.01),而NF组较N组提高更显著(P<0.01)。NF组的平均清醒时间(3.76±1.70)h及症状消失时间(6.92±2.86)h均明显短于N组[(5.17±1.93),(10.43±2.78)h](P<0.01)。无明显副作用。结论纳络酮和氟吗西尼都是治疗急性重度酒精安定混合中毒的有效药物,而两药联合使用的疗效更较纳络酮明显。
Objective To observe the efficacy and safety of naloxone combined with benzodiazepine receptor antagonist flumazenil in the rescue of acute alcohol poisoning. Methods Eighty-five patients were randomly divided into two groups: N group (n = 43), naloxone (0.8-2 mg) added with 5% GS 20 ml intravenously, and then repeated 0.4 mg every 10 minutes until awake or total 4 mg; NF group, 42 cases, naloxone treatment at the same time, the use of flumazenil 0.3mg added 5% GS 20ml intravenous, if not awake, repeat every 0.1min 0.1mg, until the awakening or the total amount of 2mg . The SBP, HR, RR, GCS scores and the patients’ wakefulness and symptom disappearance time before and after treatment were recorded respectively. Results The SBP, HR, RR and GCS scores of both groups were significantly higher than those before treatment (P <0.01), while those of NF group were significantly higher than those of N group (P <0.01). The average awake time (3.76 ± 1.70) h and symptom disappearance time (6.92 ± 2.86) h in NF group were significantly shorter than those in N group [(5.17 ± 1.93) and (10.43 ± 2.78) h], respectively. No obvious side effects. Conclusions Both naloxone and flumazenil are effective drugs for the treatment of acute severe alcohol-stable mixed poisoning, and the curative effect of the two drugs is more obvious than that of naloxone.