纳洛酮联合醒脑静抢救急性重度酒精中毒研究

Naloxone combined with xing-nao-jing for treatment of acute severe alcoholism

目的:探讨纳洛酮联合醒脑静注射液在抢救急性重度酒精中毒中的作用。方法:2006年1月至2008年5月117例在重庆医科大学附属第一医院急诊科抢救的急性重度酒精中毒病人随机分为3组:单纯醒脑静注射液治疗组(X组);单纯纳洛酮治疗组(N组)和醒脑静注射液联合纳洛酮治疗组(XN组)。监测并记录呼吸频率、SBP、体温初次恢复时间,清醒时间,治疗1、4、8h后呼吸频率、收缩压、瞳孔、SPO2、PaO2和氧和指数。结果:呼吸频率、SBP、体温的初次恢复时间XN组与N组相当(P>0.05),初次苏醒时间优于X组,但X组呼吸与体温恢复速度稍慢。在治疗4h、8h后反映循环功能恢复的指标SBP,XN组优于N组。在治疗8h后PaO2/FiO2XN组优于X组和N组。同时,苏醒后患者头晕头痛、恶心呕吐、心悸胸闷症状较单纯使用纳洛酮组少(P<0.05)。结论:在抢救急性重度酒精中毒过程时,醒脑静注射液与纳洛酮合用具有协同效应,能够及时、有效的恢复患者呼吸循环功能,减轻临床其他症状,疗效准确,安全,较单独分别使用时好,可以在临床急救中使用。

Objective：To investigate the effect of naloxone combined with xing-nao-jing injection in rescuing acute severe alcoholism. Methods：117 with acute severe alcoholism,who were admitted to the department of emergency of the First Affiliated Hospital of the Chongqing Medical University between January 2006 and May 2008,were randomly divided into the X-group（the treatment of xing-nao-jing injection simply）,N-group（the treatment of naloxone simply）and XN-group（the treatment of naloxone combined with xing-nao-jing injection）.Breathing frequency（BR）,systolic blood pressure（SBP）,the recovery time of temperature,and the wake-up time were monitored and recorded.Then BR,SBP,the diameter of pupil,SPO2,PaO2 and FiO2/PaO2 at 1,4 and 8 h after the treatment were recorded.Results：The recovery times of BR,SBP and temperature in XN-group were equal to those of N-group（P0.05）.The wake-up times in above-mentioned two groups were shorter than that in X-group,and the recovery times of BR and temperature were shorter than that in X-group.SBP of XN-group were better than that of N-group at 4 and 8 h after the treatment.PaO2/FiO2 of XN-group was better than that of N-group and X-group at 8 h after the treatment.Meanwhile the symptoms after the patients came around,including dizzy and headache,nausea and vomiting,palpitation and chest distress,were fewer in XN-group than those in N-group（P0.05）. Conclusion：In the process of rescuing acute severe alcoholism,there were synergistic effect between xing-nao-jing injection and naloxone.Breath and circulation could be recovered promptly and effectively by the treatment of naloxone combined with xing-nao-jing injection.And it could relieve the symptoms,with better effects than single use of xing-nao-jing injection or naloxone.