不同剂量纳洛酮在院前急救意识障碍治疗中的应用价值

Application value of different doses naloxone in the treatment of consciousness disorder in pre hospital emergency

目的:探讨不同剂量纳洛酮在院前急救意识障碍治疗中的应用价值。方法:选取2017-01—2019-10期间在我院院前急救的意识障碍患者102例,根据救治方案分为观察组54例和对照组48例。观察组给予4mg纳洛酮静脉滴注,对照组给予2mg纳洛酮静脉滴注,观察两组治疗24h内清醒率、格拉斯哥昏迷(GCS)评分、不良反应等,检测治疗前后胱抑素C(CysC)、S100β、N末端前脑钠肽(NT-proBNP)水平。结果:观察组治疗24h内清醒率为79.63%,明显高于对照组(P<0.05),而治疗至清醒的时间为(220.54±89.94)min,明显快于对照组(P<0.05);观察组治疗后GCS评分为(15.51±1.12)分,明显高于对照组(P<0.05);观察组治疗后血清CysC、S100β、NT-proBNP分别为(0.80±0.24)mg/L、(0.75±0.23)g/L和(105.67±34.22)pg/mL,明显低于对照组(P<0.05);观察组和对照组不良反应发生率比较差异无统计学意义(P>0.05)。结论:4mg纳洛酮静脉滴注在院前急救意识障碍治疗中有较好的临床效果,值得临床使用。

Objective:To explore the value of different dosesnaloxone in the treatment of consciousness disorder in pre hospital emergency.Method:From January 2017to October 2019,102patients with consciousness disorder were selected for emergency treatment in our hospital,according to the treatment plan,the patients were divided into the observation group(n=54)and the control group(n=48).The observation group was given 4mg naloxone intravenously,while the control group was given 2mg naloxone intravenously.The recovery rate,Glasgow Coma(GCS)score and adverse reactions were observed,the levels of cystatin C(CysC),S100β,and N-terminal forebrain natriuretic peptide(NT-proBNP)were measured before and after treatment.Result:The recovery rate in the observation group was 79.63%,which was significantly higher than that in the control group(P<0.05),and the time from treatment to recovery was(220.54±89.94)min,which was significantly faster than that in the control group(P<0.05).After treatment,the GCS score of the observation group was(15.51±1.12),which was significantly higher than that of the control group(P<0.05).The serum CysC,S100,NT-proBNP of the observation group were(0.80±0.24)mg/L,(0.75±0.23)g/L and(105.67±34.22)pg/mL,which were significantly lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:4mg naloxone intravenously has a good clinical effect in the treatment of consciousness disorder in pre hospital emergency,which is worth to use in clinic.