早期反复大剂量纳洛酮治疗重度CO中毒患者的临床研究  

Clinical Study of Early Repeated High Dose Naloxone in the Treatment of Severe CO Poisoning

作　　者：王红娟 WANG Hong-juan

机构地区：[1]庆阳市人民医院,甘肃庆阳745000

出　　处：《中国初级卫生保健》2020年第2期100-102,共3页Chinese Primary Health Care

摘　　要：目的探讨早期反复大剂量纳洛酮治疗重度一氧化碳(CO)中毒患者的临床疗效。方法选取重度CO中毒患者64例,随机分为对照组和观察组,每组各32例。对照组采用常规治疗。观察组在此基础上,联合反复大剂量纳洛酮治疗。比较两组患者疗效及预后情况。结果治疗后,观察组的总有效率(87.50%),高于对照组(62.50%);观察组患者的Glascow昏迷评分与Barthel指数优于对照组;观察组死亡率为6.25%,低于对照组的25.00%;观察组患者72 h内苏醒率为87.50%,高于对照组的75.00%,P<0.05。3个月内,观察组患者中发生迟发性脑病2例(6.25%),低于对照组的9例(28.13%),P<0.05。结论早期大剂量纳洛酮治疗急性CO中毒疗效确切,改善患者昏迷情况,缩短昏迷时间,降低死亡率及迟发性脑病的发病风险。OBJECTIVE To investigate the clinical efficacy of early repeated high dose naloxone in the treatment of severe CO poisoning. METHODS 64 patients with severe carbon monoxide poisoning were selected from the emergency department of Qingyang People’s Hospital. According to the random number table method, the patients were divided into control group and observation group, 32 cases in each group. The control group was treated with hyperbaric oxygen combined with mannitol, vitamin C and Xingnaojing. On the basis of routine treatment, the observation group was treated with repeated high-dose naloxone. Glascow coma score, Barthel index, mortality, recovery time and incidence of delayed encephalopathy within 3 months after recovery were compared between the two groups. RESULTS The total effective rate of the observation group(87.50%)was higher than the control group(62.50%). After treatment, the Glascow coma score and Barthel index were better than the control group in the observation group;the mortality rate of the observation group was 6.25%, lower than the control group. 25.00% of the group;the recovery rate of the observation group was87.50% within 72 hours, which was higher than that of the control group(75.00%), the difference was statistically significant, P<0.05.Within 3 months, 2 patients(6.25%)had delayed encephalopathy in the observation group, and 9 patients(28.13%)had delayed encephalopathy in the control group,P<0.05. The incidence was statistically significant. CONCLUSION Early high dose naloxone is effective in treating acute CO poisoning. It could effectively improve coma, shorten coma time, reduce mortality and risk of delayed encephalopathy, and improve prognosis of patients.

关 键 词：纳洛酮 早期 CO中毒 苏醒时间 昏迷评分 

分 类 号：R595.1[医药卫生—内科学]