纳洛酮救治溺水儿童临床疗效观察

Clinical observation of naloxone treatment in drowing children

目的 探讨纳洛酮治疗溺水儿童的临床疗效及可能机制.方法 回顾性分析我院救治的97例溺水儿童的临床资料,根据是否应用纳洛酮分成治疗组45例和对照组52例,治疗组在综合治疗的基础上入院后给予纳洛酮0.4～0.8 mg/次,每4～6小时1次,疗程4～5 d,比较分析两组患儿的临床治疗效果、主要症状持续的天数及治疗前后血浆β-内啡肽水平.结果 治疗组的总有效率为93.3%（42/45）,对照组为76.9%（40/52）,差异有显著性（x2=8.1,P＜0.05）;治疗组存活者神经系统病残率为33.3%（14/42）,对照组为65.0%（26/40）,差异有非常显著性（x2=8.2,P＜0.01）;治疗组循环不良、呼吸不规则、抽搐、昏迷的持续天数显著短于对照组（t值分别为3.1、7.7、9.3和5.8,P＜0.01）;疗程结束后治疗组血浆β-内啡肽水平显著低于对照组（t=17.1,P＜0.01）.结论 纳洛酮治疗溺水儿童临床疗效显著,其机制可能与抑制β-内啡肽有关.

Objective To investigate the clinical effects and mechanism of naloxone treatment in drowing children.Methods A total of 97 drowing children were divided into treatment group（n=45）and control group（n=52）depending on whether the naloxone was administrated.General treatment was adopted in two groups.Treatment group Was given naloxone.The clinical effects were observed and the levels of betaendorphin（β-EP）in blood plasma were measured with radioimmunoassay（RIA）before and after treatment respectively.Results The total effective rate of treatment group（93.3%,42/45）Was significantly higher than that of control group（76.9%,40/52）（P〈0.05）.As compared with that of control group（65.0%,26/40）,nervous system disability rate in treatment group（33.3%,14/42）decreased significantly（P〈0.01）.Continuous days of poor blood circulation,abnormal respiratory rhythm,convulsion and coma in treatment group were significantly shorter than those of control group respectively（P〈0.01）.The level of β-EP was significantly lower in treatment group than that of control group（t=17.1,P〈0.01）.Conclusion Clinical use of naloxone in the drowing children has curative result by reducing the level of blood plasma β-EP.