纳络酮救治57例复方地芬诺酯中毒的临床分析

目的探讨复方地芬诺酯中毒的临床表现、预防和纳络酮在其中毒救治中的应用体会。方法57例均有复方地芬诺酯服药史,采用纳络酮首次剂量0.03~0.05mg/kg,静脉推注治疗,根据患儿轻重程度2h后可重复使用,重度患儿治疗好转后改为静脉滴注,10~20μg/（kg.h）,维持2~3d后酌情停药。结果55例患儿治愈出院,死亡2例,治愈率96.5%。结论复方地芬诺酯治疗小儿腹泻不良反应大,安全范围小,建议临床对小儿慎用或禁用。早期应用纳络酮是抢救复方地芬诺酯中毒成功的关键,一经确诊,纳络酮应用要早,剂量要足,疗程要够。

Clinical Analysis Of Effect of Naloxone on 57 Children with Lomotil Overdosage

Objective To investigate the clinical manifestation and prevention of lomotil overdosage, and the effect of naloxone on children with lomotil overdosage. Methods There were 57 children who have taken compound diphenoxylate, first dosage of naloxone （0.03-0.05 mg/kg） were given by intravenous injection, and the same dosage can be give again 2 hours later if necessary. If patients＇ condition became better,naloxone（ 10-20 μg · kg^-1· h^-1 ） should be given by intravenous drip and stopped in 2 or 3 days conditionally. Results 55 children were healed,2 dead,the cure rate was 96.5%. Conclusions Compound diphenoxylate has more adverse effects and small safety range for treating children with diarrhea, so it is banned or be use with caution. Using full dose naloxone earlier is the key of treating children with lomotil overdosage.