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目的:探讨纳洛酮治疗婴儿呼吸暂停的疗效。方法:景德镇市妇幼保健院2006年12月至2011年12月收治的婴儿继发性呼吸暂停40例,按入院时间顺序随机分为治疗组(奇数日入院)和对照组(偶数日入院)各20例。治疗组在首次出现呼吸暂停后立即给予纳洛酮0.4 mg静脉注射,每6 h 1次,呼吸暂停控制后逐渐减量,用至呼吸暂停发作停止后5 d停药。对照组在首次出现呼吸暂停后立即给予氨茶碱治疗,首次负荷剂量5 mg/kg加入5%GS 30 mL中静脉滴注,30 min用完,12 h后给予维持剂量2.5 mg/kg加入5%GS 30 mL中静脉滴注,速度1 mg/(kg.h),每12 h 1次,用至呼吸暂停终止发作后5 d或用至出现不良反应后停药。两组患儿均采用常规治疗方法,包括吸氧、抗感染、保持呼吸道通畅、维持电解质平衡及酸碱平衡、微量泵输液、保持正确的体位、弹足底、托背呼吸加唤醒刺激等。如上述常规方法无效,出现发绀,立即进行复苏囊加压给氧。结果:治疗组显效10例,有效8例,无效2例;对照组显效8例,有效7例,无效5例。两组显效率和总有效率比较差异均有统计学意义(P<0.05,P<0.01)。结论:纳洛酮治疗婴儿呼吸暂停显效快,疗效好,较为安全,可作为治疗婴儿呼吸暂停的首选药物。
Objective: To investigate the efficacy of naloxone in the treatment of infant apnea. Methods: 40 cases of infant secondary apnea admitted from December 2006 to December 2011 in Jingdezhen MCH hospital were randomly divided into treatment group (odd-numbered days) and control group (even-numbered days) 20 cases. In the treatment group, naloxone 0.4 mg was given intravenously immediately after the first apnea, and once every 6 h. The apnea-hypopnea was gradually reduced after the apnea control, and was stopped 5 d after the onset of apnea. The control group was treated with aminophylline immediately after the first apnea. The first dose of 5 mg / kg was added to 5% GS 30 mL for intravenous instillation. After 30 min, the control group was given a maintenance dose of 2.5 mg / kg 5 % GS 30 mL intravenous infusion, the speed of 1 mg / (kg.h), once every 12 h, until the onset of apnea to terminate 5 days after the onset or until the adverse reactions after stopping. The two groups of children were treated with conventional methods, including oxygen, anti-infection, maintain airway patency, maintain electrolyte balance and acid-base balance, trace pump infusion, to maintain the correct position, bomb foot, back care breathing plus wake-up stimulation. Such as the above conventional method is invalid, appear cyanosis, immediately resuscitation capsule pressure to oxygen. Results: The treatment group markedly effective in 10 cases, effective in 8 cases, 2 cases; control group markedly effective in 8 cases, effective in 7 cases, ineffective in 5 cases. There was significant difference between the two groups in apparent efficiency and total effective rate (P <0.05, P <0.01). Conclusion: Naloxone is effective in treating apnea in infants. It is safe and can be used as the first choice of drug for treating infant apnea.