东莨菪碱伍用纳曲酮和纳洛酮快速脱毒治疗海洛因依赖者临床分析

目的 观察东莨菪碱伍用纳曲酮和纳洛酮对海洛因依赖者快速脱毒治疗的疗效及其安全性。方法 东莨菪碱伍用纳曲酮和纳洛酮对８４例海洛因依赖者快速脱毒治疗以及用动态心电观察其治疗期间的心率，血压，呼吸和血氧饱和度，纳洛酮催促试验和纳曲酮维持来评价快速脱毒的疗效。结果 ８４例海洛因依赖者经快速脱毒治疗在６－８小时内控制戒断症状，在快速转入纳曲酮维持治疗时，均无痛苦的主观体验，其平均住院时间减少，疗程中，有１９

The combined use of scopolamine, naltrexone and naloxone as a rapid, safe and effective detoxification treatment for heroin addicts

Objective To evaluate the efficacy of a rapid detoxification schedule for heroin addicts by scopolamine combined with opiate receptor antagonists.Methods The life signs such as temperature, blood pressure, ECG, heart rate, respiratory rate and blood oxygen saturation were monitored during the process of rapid detoxification treatment. The naloxone challenge test, withdrawal symptoms scale and naltrexone maintenance were used to evaluate the efficacy of the rapid detoxification. Results The withdrawal symptoms of 84 heroin addicts induced by naltrexone and naloxone were controlled completely under scopolamine administration in the 6 8 hours treatment period, although the naloxone challenge test was able to induce slight and transient withdrawal symptoms in the second day, and all patients were transferred rapidly to naltrexone maintenance. During treatment, the temperature in 19 cases elevated, and all patients showed increased heart rate, blood pressure and respiratory rate. However, the blood oxygen saturation was still stable after oral administration of naltrexone and continuous injection of naloxone during the detoxification. Blood test in gastric fluid was positive in 3 cases during the detoxification. The follow up data showed that the average maintenance time of naltrexone was 2.6 months, and the percentage of drug free was 21% in 6 months after the detoxification in 84 cases. Conclusion The combined use of scopolamine, naltrexone and naloxone is a rapid, safe and effective detoxification treatment protocol for heroin addicts.