纳洛酮的稳压效应及在脑出血急性期的应用价值

目的　观察纳洛酮对血压的作用机制及实际疗效 ,探讨脑出血患者急性期应用纳洛酮的价值。方法　①随机将院前急救的 10 0例脑出血患者分为纳洛酮治疗组和对照组各 5 0例 ,前者以常规抢救为基础 ,再给予纳洛酮0 .8～ 1.6mg静脉注射 ,另选择 5 0例血压无明显变化的脑梗死患者作为参考组 1,5 0例血压低于正常的乙醇、一氧化碳中毒的患者作为参考组 2 ,参考组均在常规治疗的基础上加用纳洛酮。②监测四组患者发病及抢救后不同时间血压变化及意识、呼吸和心率的改变。结果　不论高血压、低血压患者使用纳洛酮后 ,血压均趋向正常。脑出血治疗组在配合应用纳洛酮后血压稳步下降 (P <0 .0 5 ) ,与对照组相比 ,在用药 30分钟后作用显现 (P <0 .0 5 ) ,收缩压与舒张压下降幅度大致同步 ,参考组 1血压波动不大 (P >0 .0 5 ) ,参考组 2血压在用药后 1小时内回升至正常 ,收缩压升幅明显 (P <0 .0 1)。结论　纳洛酮作为阿片受体拮抗剂 ,从多个环节对血压产生稳定作用 ,脑出血急性期应用纳洛酮可明显改善患者的血压、意识、呼吸和心率 ,有助于提高抢救成功率

Effect of naloxone on blood pressure and its value on acute cerebral hemorrhage

Objective Observe the mechanism of effect and curative effect of naloxone on blood presure,discuss the value of the patients of cerebral hemorrhage cured by naloxone in acute time.Methods 1,Divide at random 100 cases of cerebral hemorrhage of prehospiteal emergency medical care into two groups,the first,as comparison,is given the normal emergency treatment,the second,as the curing group,is injected 0.8 1.6 mg naloxone into veins based on the normal emergency treatment.The third,choose 50 cases of cerebral infarction who has no change of blood pressure as refernce group one.Choose 50 cases of alcohoic intoxication and gas poisoing with blood pressure were lower than normal human as refernce group two,all of referece groups are injected naloxone into veins based on normal treatment.2,Before and after giving emergency treatment,watch in different time the changes of blood pressure and consciousness,frequence of breath and heart of four groups of patients.Results The blood pressure would be going normal after giving naloxone into veins whether the blood pressure is higher or not.Conclusion As opioid receptor antagonist naloxone would steady the blood pressure from many link for the acute cerebral hemorrhage. Naloxone would improve the blood pressure,consiousness,frequence of breath and heart of patients, and would be conductive to raising the success rate of emergency treatment.