纳洛酮在心肺脑复苏患者中的辅助治疗作用

Role of naloxone adjuvant therapy in patients with cardiopulmonary cerebral resuscitation

目的探讨纳洛酮在心肺脑复苏(CPCR)患者中的辅助治疗作用。方法将126例心脏骤停患者随机分为治疗组及对照组,每组63例。对照组给予CPCR常规治疗措施,治疗组在对照组基础上加用纳洛酮注射液静脉推注。比较治疗24h后2组患者急性生理和慢性健康状态评分(APACHEⅡ评分)、格拉斯哥昏迷指数评分(GCS评分)变化;比较2组自主循环恢复率、恢复时间,自主呼吸恢复率、恢复时间,复苏成功率及48 h存活率。结果 2组患者治疗24 h后APACHEⅡ及GCS评分平均值较治疗前显著改善,且治疗组改善幅度大于对照组;治疗组患者自主循环及自主呼吸恢复率、复苏成功率及48 h存活率均显著高于对照组,而恢复时间显著短于对照组。结论在常规CPCR基础上,联合应用纳洛酮可显著提高心脏骤停患者的自主循环及自主呼吸恢复率,缩短自主循环及自主呼吸恢复时间,从而提高复苏成功率,降低病死率,可作为心脏骤停的药物辅助治疗药物。

Objective To explore the role of naloxone adjuvant therapy in patients with cardiopulmonary cerebral resuscitation（CPCR）.Methods One hundred and twenty-six patients with cardiac arrest were randomly divided into treatment group and control group,63 in each group.The control group was administered routine CPCR regime,whereas the treatment group was intravenously administered naloxone injection based on the regime of the control group.The changes of acute physiology and chronic health evaluation score（APACHE Ⅱ score） and Glasgow coma scale score（GCS score） were compared in two groups 24 h after treatment,and the recovery rate and time of spontaneous circulation,recovery rate and time of spontaneous respiration,success rate of resuscitation and 48 h survival rate of patients were compared in two groups.Results The mean values of both APACHE Ⅱ and GCS scores 24 h after treatment significantly improved in comparison with treatment before,while the improved range in the treatment group was larger than that in the control group.The recovery rates of spontaneous circulation and respiration,success rate of resuscitation and 48 h survival rate of patients in the treatment group were all higher than those in the control group conspicuously,whereas the recovery time was markedly shorter than that in the control group.Conclusion Based on routine CPCR regime,the combination of naloxone can notably enhance the recovery rate of spontaneous circulation and respiration of patients with cardiac arrest and shorten their recovery time of spontaneous circulation and respiration,consequently leading to the improvement of success rate of resuscitation and decrease of mortality,so it can be considered as one of the adjuvant drugs for cardiac arrest.