论文部分内容阅读
目的:探讨不同剂量纳络酮对本地区急性昏迷(饮酒的同时服用较大剂量的安定)患者的临床应用效果。方法:①应用前瞻性研究方法,将急诊就医和院前呼救昏迷时间在6h以内的急性昏迷患者作第一次Glasgow评分,Glasgow评分在6～10分的急性昏迷患者296例列入本研究。②将所有患者随机分成对照组和纳洛酮治疗1组、2组、3组和4组。在对原发病治疗的同时,对照组使用5%葡萄糖注射液250ml加美解眠注射液200mg静脉滴注,治疗组分别加用纳洛酮0.4mg,1.2mg,2.0mg和5.0mg稀释到20ml后静脉推注,每2小时1次。对入选患者取动脉血进行动脉血气分析、取静脉血检测电解质等,根据资料作第一次APACHE-II评分,在24和48h分次进行APACHE-II评分。③病例观察指标:认真观察记录患者苏醒时间,治疗后1/2、1、2、4、8、12、24、48和72hGlasgow评分和血压等。结果:各组2种评分无统计学意义,治疗组完全苏醒时间与对照组相比差异分别有统计学意义(P<0.01),且头痛,肌肉松弛无力等症状减少,治疗3组和治疗4组差异无统计学意义(P>0.05)。结论:纳络酮对乙醇和镇静剂联合中毒所致的急性昏迷,具有较强地催醒作用,在一定的范围内存在剂量的依赖关系。
Objective: To investigate the clinical effects of different doses of naloxone in patients with acute coma (drinking alcohol while taking a larger dose of diazepam). Methods: ①The first Glasgow score was used in patients with acute coma who were hospitalized for emergency and hospitalized for comatose time within 6 hours and 296 acute coma patients with Glasgow score between 6 and 10 were included in this study. ② All patients were randomly divided into control group and naloxone treatment group 1, group 2, group 3 and group 4. In the treatment of the primary disease at the same time, the control group using 250ml of 5% glucose injection and the United States Xie Mian injection 200mg intravenous infusion, the treatment group were added with naloxone 0.4mg, 1.2mg, 2.0mg and 5.0mg diluted to 20ml Post-intravenous bolus, once every 2 hours. The selected patients were taken arterial blood gas analysis of arterial blood, venous blood electrolyte detection, etc., according to the data for the first APACHE-II score, APACHE-II scores in 24 and 48h graded. Â ’¢ case observation indicators: careful observation of patients recorded wake time, after treatment 1 / 2,1,2,4,8,12,24,48 and 72h Glasgow score and blood pressure. Results: There was no significant difference between the two groups in the scores of the two groups. There was significant difference in the complete recovery time between the treatment group and the control group (P <0.01), and the symptoms such as headache and muscle weakness were reduced. The treatment group 3 and treatment 4 There was no significant difference between the two groups (P> 0.05). Conclusion: Naloxone can induce acute coma caused by ethanol and sedatives poisoning, and it has a strong reminding effect. There is a dose-dependent relationship within a certain range.