纳美芬在抢救重度毒鼠强中毒中的疗效观察

目的 探讨纳美芬在抢救重度毒鼠强中毒中的应用价值.方法 选取2009年1月至2012年10月在解放军第九八医院急诊科就诊的急性重度毒鼠强中毒患者50例,完全随机分为观察组和对照组,各25例,观察组给予常规综合治疗加纳美芬首剂0.2～0.3 mg静脉注射治疗,继而予以0.2 ~0.4 mg静脉滴注,1~2次/d,连续使用3～5 d,一般意识恢复12～36 h后改用0.1 mg静脉注射,2次/d,连用7 d.对照组给予常规综合治疗.比较2组患者治疗后12、24、48、72 h血浆β内啡肽、脑氧摄取水平以及催醒时间、预后情况及不良反应.结果 2组患者血浆β内啡肽随时间逐步下降,观察组治疗后72 h β内啡肽[（65±4）ng/L]低于对照组[（74±7）ng/L].2组患者脑氧摄取水平逐步升高,观察组治疗后72 h脑氧摄取[（36.9±2.9）%]高于对照组[（33.0±2.7）%].观察组的催醒时间低于对照组[（5.1±1.0）h]比[（7.2±1.5）h],总有效率高于对照组[96%（24/25）]比[88%（22/25）],差异均有统计学意义（均P〈0.05）.结论 纳美芬对急性重度毒鼠强中毒疗效确切,可明显降低致残率,改善重度毒鼠强中毒患者的预后.

The clinical observation of nalmefene in the treatment of severe tetramine intoxication

Objective To investigate the effects of nalmefene in the treatment of severe tetramine intoxication. Methods From January 2009 to October 2012, fifty patients with severe tetramine intoxication were randomly divided into two groups：observation group（basic treatment combined with nalmefene） and control group（basic treatment）. The level of β-endorphin and brain oxygen uptake （CEO2）after the treatment for 12, 24, 48 and 72 h, the palinesthesia time,prognosis and adverse reactions were compared between the two groups. Results β-endorphin levels for 72 h in observation group[（65＋4）ng/L] was lower than that in control group[（74＋7）ng/L]; CEO2 for 72 h[（36.9＋2.9）%]was higher than that in control group[（33.0＋2.7）%]; The palinesthesia time[（5.1±1.0）h] was shorter than that in control group[（7.2±1.5）h] （all P〈0.05）. Conclusion Nalmefene can significantly reduce morbidity and improve the prognosis of the patients with severe tetramine intoxication.