大剂量纳络酮治疗醉酒后重型颅脑损伤的临床研究

Clinical Study on High Dose of Naloxone for the Trea tment of Post-intoxicated Severe Celebral Injury

目的探讨大剂量纳络酮对醉酒后重型颅脑损伤的治疗作用。方法大剂量纳络酮治疗醉酒后重型颅脑损伤患者46例与同等条件下但未用纳络酮治疗的同类患者46例比较。结果将恢复良好、中残、重残合称为治疗有效,将植物生存、死亡合称为治疗无效,纳络酮实验组治疗有效33例(占71.74%),无效13例(占28.26%),有效组(n=33)觉醒天数为(11.31±4.71)d;对照组(n=23)分别为23例(占50.0%)及23例(占50.0%),觉醒天数为(15.19±5.83)d。两组比较均有显著性差异(P<0.05或P<0.01)。实验组血浆β-内啡肽(β-EP)均值较对照组极其显著下降(P<0.01)。结论醉酒后重型颅脑损伤患者早期应用大剂量纳络酮治疗可明显提高临床疗效,缩短昏迷时间,治疗过程中未见毒副作用。

Objective To study the therapeutic impact of high dose of naloxone on post-intoxicated severe celehral injury. Methotis High dose of naloxone was administered to 46 patients with post-intoxicated severe celebral injury, and the therapeutic impact was then compared with 46 patients with the same injury. Results Excellent recovery and moderate or severe disability were regarded as therapeutically effective, and vegetative nervous survival and death as noneffective. In the naloxone group, there were 33 patients （71.74%） with effective therapeutic result and 13 ones （28.26%） with noneffective sequel, while in the control group the numbers were both 23 （50.00%）. As for consciousness recovery time （in which the coma patients began coming to consciousness）, the two groups＇durations were respectively 11.31 ± 4.71 （ n = 33 ） and 15. 19 ± 5.83 （ n = 23 ）. There were significant differences in both therapeutic effect and consciousness recovery time （ P 〈 0.05 or P 〈 0.01 ）. Furthermore, the naloxone group got a obvious decrease in beta - endorphin in plasma when compared with the control group （ P 〈 0.01 ）. Conclusion Not only the application of high dose of naloxone has an obvious impact on post-intoxicated severe celebral injury without adverse reaction, but the coma duration is shortened as well.