纳络酮、氟吗西尼与联合使用纳络酮与氟吗西尼治疗急性安定中毒的疗效和安全性比较

目的观察纳络酮、氟吗西尼、联合使用纳络酮和氟吗西尼治疗急性安定中毒的疗效和安全性.方法将45例安定中毒患者随机分为纳络酮组(15例)、氟吗西尼组(15例)和联合使用纳络酮、氟吗西尼治疗组(15例).三组患者在常规治疗相同情况下,在相同时间内分别用纳络酮、氟吗西尼、纳络酮和氟吗西尼治疗,对三组患者,在治疗0、5、15、60、90、180min进行镇静催眠评分,并作相关的常规及生化检查,持续监测患者生命体征、氧饱和度.结果联合用药组的早期治疗有效率高于单独使用纳络酮组(P＜0.05),但观察终点治疗有效率无显著性差别.镇静催眠评分比较,使用氟吗西尼的两组在治疗过程中均要低于纳络酮组,联合使用两种药物治疗组更低,且有显著性差异.三组并发症比较无明显差异.结论纳络酮,氟吗西尼都是治疗安定类药物中毒的有效药物,联合使用纳络酮和氟吗西尼是疗效体现更早、最终治疗结果更好.

A Clinical Comparison of the Therapeutic Effect and Safety of Naloxone, Flumazenil and Naloxone Combining Flumazenil in Treatment of Acute Poisoning by Diazepam

Objective To compare the therapeutic effect and safety of naloxone ,flumazenil and naloxone combined wiht flumazenil in treating acute diazepam poisoning and to find out ideal therapeutic treatment.Methods 45 patients were divided into three groups at random: naloxone group (n=15), flumazenil group (n=15) and naloxone combined with flumazenil group (n=15). Besides given the same routine therapy to each group, naloxone group received 0.4mg naloxone through intravenation and 1.2mg naloxone through intravenous drip; flumazenil group received 0.1mg flumazenil through intravenation and 0.9mg flumazenil through intravenous drip; naloxone combined with flumazenil group received 0.4mg naloxone and 0.1mg flumazenil through intravenation and 1.2mg naloxone and 0.9mg flumazenil through intravenous drip. Each patient's consciousness status was graded after given drug treatment 0, 5,15,60,90,180 minute. Testing the BR, SR, CK, CK-MB of every patient and recording to the Bp, HR, RR, SpO 2 and the rhythm of the heart continuously. Results At the point of 5 minute, the therapeutic efficiency of the group with combined drug use was higher than that of the naloxone group ( P <0.05). As to the consciousness status, the grades of two groups' injected flumazenil were lower than that of the group only injected naloxone, furthermore in the group with combined drug use was the lowest. No significant difference of complications was found among the three groups.Conclusions Both naloxone and flumazenil are effective to treat the acute poisoning of diazepam, but the method of naloxone combined with flumazenil is more effective than each of them.