等量纳洛酮不同用药方案治疗重度酒精中毒的效果比较

Comparison of Effects of Different Medication Schemes with the Same Dose of Naloxone in the Treatment of Severe Alcoholism

目的:研究等量纳洛酮不同用药方式治疗重度酒精中毒的效果,并寻求最佳用药方式。方法:选取本院2017年1月-2019年12月诊治的180例重度酒精中毒患者,按照随机数表法将患者分为A、B、C组,各60例。A组:纳洛酮0.8 mg/15 min静脉注射治疗,给药12次;B组:纳洛酮1.6 mg/30 min静脉注射治疗,给药6次;C组:每小时以纳洛酮3.2 mg+0.9% NaCl注射液250 ml静脉泵入,给药3 h。观察并记录治疗后1、2、4 h三组呼吸频率、收缩压和氧合指数等指标的变化,同时比较三组意识恢复时间、平稳呼吸恢复时间、谷丙转氨酶(GPT)及不良反应情况。结果:治疗后2、4 h,C组收缩压高于B组,差异有统计学意义(P<0.05);治疗后4 h,C组氧合指数显著高于A组和B组(P<0.05)。B组和C组意识恢复时间、平稳呼吸恢复时间、GPT明显优于A组(P<0.05),且C组明显优于B组(P<0.05)。C组不良反应发生率显著低于A组和B组(P<0.05)。结论:纳洛酮静脉泵入对治疗重度酒精中毒疗效更明显,不良反应少,促醒速度快,值得推广。

Objective:To study the effects of different medication schemes of same dose of Naloxone in the treatment of severe alcoholism,so as to find out the best medication method.Method:A total of 180 patients with severe alcoholism diagnosed and treated in our hospital from January 2017 to December 2019 were selected.The patients were divided into the group A,B,C according to the random number table method,60 cases in each group.Group A:Naloxone was intravenously injected 0.8 mg/15 min for 12 times;group B:Naloxone was intravenously injected 1.6 mg/30 min for 6 times;group C:Naloxone 3.2 mg+0.9% NaCl injection 250 ml was intravenously pumped every hour,for 3 h.Changes in respiration rate,systolic blood pressure and oxygenation index at 1,2,4 h after treatment among the three groups were observed and recorded.Meanwhile,consciousness recovery time,steady breathing recovery time,glutamic-pyruvic transaminase (GPT) and adverse reactions among the three groups were comparatively analyzed.Result:At 2,4 h after treatment,the systolic blood pressure in the group C was higher than that in the group B,and the difference was statistically significant (P<0.05);at 4 h after treatment,the oxygenation index of the group C was significantly higher than that of the group A and B (P<0.05).The consciousness recovery time,steady breathing recovery time and GPT of the group B and C were significantly better than those of the group A (P<0.05);the above indexes in the group C were significantly better than those in the group B (P<0.05).The incidence of adverse reactions in the group C was significantly lower than that in the group A and B (P<0.05).Conclusion:Intravenous pumping of Naloxone is more effective in the treatment of severe alcoholism,with fewer adverse reactions and better wake-promoting effect,which is worthy of promotion.