氟马西尼治疗25例苯二氮类药物中毒的疗效

Clinical evaluation of flumazemil in the treatment of BZDs toxication

目的:评价氟马西尼治疗苯二氮类药物(BZDs)中毒患者的疗效和安全性。方法:选择我院急救中心BZDs急性中毒患者50例,随机分为常规治疗组和氟马西尼组各25例,常规治疗为洗胃后给予静脉输入5％葡萄糖溶液,维生素C 6 g·d-1和10％氯化钾3～5 g·d-1静脉滴注,呋塞米利尿、导泻以及抗生素预防性治疗。氟马西尼组在常规治疗基础上用氟马西尼0．25～0．5 mg静注,随后予氟马西尼10μg·min-1静脉泵入,至患者清醒或总量1 mg,如未清醒或再昏迷者继续给予氟马西尼5μg·min-1静脉泵入维持。将两组患者治疗前后昏迷深度评分和机敏力／镇静程度评判量表(OAA／S)得分以及治疗后的平均意识恢复时间和平均住院日进行统计学分析。结果:氟马西尼组昏迷深度评分、OAA／S得分、平均意识恢复时间和平均住院日均小于常规治疗组(P<0．01)。结论:氟马西尼可作为治疗急性BZDs中毒的首选药物之一。

Objective：To evaluate the efficacy and safety of flumazenil in the treatment of BZDs toxication. Methods：50 patients with BZDs toxication were randomly 1：1 assigned to either conventional therapy or conventional therapy plus flumazenil regimen. The flumazenil regimen included an intravenous infusion of 0.25 -0.5 mg flumazenil at the infusion rate of 10μg· min^-1. The flumazenil was terminated after patients were conscious or administered up to the maximal dose of 1 mg, whichever was first reached. The infusion rate was adjusted to 5μg· min^-1 when patients were still unconscious or became unconscious again after the first dose of flumazenil was ended. The efficacy was assessed based on degree ot lost of consciousness and OAA/S score pre- and post the therapy and mean time of consciousness recovery and mean days of inhospitalization post the therapy. Results：The adjunctive therapy of conventional therapy with flumazenil showed the better prognosis than the conventional therapy alone in all therapeutic outcomes （P 〈 0.01 ）. Conclusion：The added-on flumazemil offered detoxication better to BZDs.