纳美芬治疗重度安眠药中毒疗效观察

Therapeutic effects of nalmefene on severe hypnotic poisoning

目的观察纳美芬治疗重度安眠药中毒的临床疗效。方法选取2012年1月至2015年12月诊治的重度安眠药中毒患者96例,随机分为对照组和观察组,每组48例。2组均给予安定中毒常规治疗(吸氧、洗胃、利尿、维持水电解质平衡、纳洛酮及对症支持治疗),观察组在常规治疗基础上给予盐酸纳美芬0.5μg/kg,静脉滴注,2次/d。比较2组临床疗效、意识清醒时间、症状缓解时间、住院时间、30 min和1 h复苏情况、生理指标、并发症发生情况及预后。结果对照组和观察组总有效率分别为70.83%、83.33%,差异有统计学意义(P<0.05)。观察组意识清醒时间、症状缓解时间及住院时间均明显短于对照组,30 min和1 h复苏情况、生理指标及预后均明显好于对照组,并发症发生率明显少于对照组(P<0.05)。结论纳美芬治疗重度安眠药中毒疗效良好,能够明显缩短患者清醒时间及病程,并减少并发症发生,改善患者预后。

Objective To observe the therapeutic effects of nalmefene on severe hypnotic poisoning.Methods Ninety-six patients with severe hypnotic poisoning who were treated from January 2012 to December 2015 were randomly divided into control group and observation group,with 48 patients in each group.The patients in both groups were treated by conventional treatment according to poisoning by diazepam,including infusion,diuretic,maintaining electrolyte balance,naloxone,oxygen inhalation,etc.The patients in observation group,on the basis of conventional treatment,were given hydrochloride nalmefene 0.5μg / kg intravenously,twice a day.After treatment,the clinical curative effects,safe consciousness time,symptomatic relief time,hospitalization time,resuscitation state on 30 min and 1h,physiological indexes,the incidences of complications and patient＇s prognosis were observed and compared between two groups.Results The total effective rates in control group and observation group were 70.83% and 83.33%,respectively,there were significant differences between two groups（ P〈0.05）.After treatment,the safe consciousness time,symptomatic relief time and hospitalization time in observation group were significantly shorter than those in control group（ P〈0.05）,moreover,the resuscitation state on 30 min and 1h,physiological indexes and patient＇s prognosis in observation group were much better than those in control group,besides,the incidences of complications in observation group were obviously fewer than those in control group（ P〈0.05）.Conclusion Hydrochloride nalmefene has better therapeutic effects on severe hypnotic poisoning,which can obviously shorten patient＇s conscious time and course of disease,and can decrease the incidences of complications and improve patient＇s prognosis.