氟马西尼及纳洛酮治疗肝昏迷的疗效比较  

Efficacy Comparison of Flumazenil and Naloxone in the Treatment of Hepatic Coma

作　　者：李继荣 王志坚 李三清 张文芳 王昌镇 倪传斌 张美君 陶保菊 LI Ji-rong;WANG Zhi-jian;LI San-qing;ZHANG Wen-fang;WANG Chang-zhen;NI Chuan-bin;ZHANG Mei-jun;TAO Bao-ju(Department of Infectious Diseases,the Second Naval Hospital of Southern Theater Command,Sanya 572000,Hainan,China;Hemodialysis Center,the Second Naval Hospital of Southern Theater Command,Sanya 572000,Hainan,China)

机构地区：[1]南部战区海军第二医院感染科,海南三亚572000 [2]南部战区海军第二医院血透中心,海南三亚572000

出　　处：《医学信息》2023年第9期120-123,共4页Journal of Medical Information

摘　　要：目的比较氟马西尼及纳洛酮在肝昏迷治疗中的临床疗效。方法选取2019年2月-2021年9月南部战区海军第二医院收治的74例肝昏迷患者作为研究对象,通过随机数字表法分为氟马西尼治疗组(38例)和纳洛酮治疗组(36例),分别给予氟马西尼和纳洛酮治疗。比较两组治疗48 h时临床症状改善总有效率、智力测验计时(NCT、DS)、神志转清时间、血清苯二氮卓(BZ)和β-内啡肽(β-EP)水平及2周后存活率。结果氟马西尼治疗组临床症状改善总有效率为86.84%,高于纳洛酮治疗组的66.67%,差异有统计学意义(P<0.05);氟马西尼治疗组NCT、DS时长短于纳络酮治疗组,差异有统计学意义(P<0.05);氟马西尼组治疗后BZ水平低于纳洛酮组,β-EP水平高于纳洛酮组,差异有统计学意义(P<0.05);氟马西尼治疗组2周后存活率为76.32%,与纳洛酮治疗组的75.00%比较,差异无统计学意义(P>0.05)。结论氟马西尼治疗肝昏迷患者的疗效优于纳洛酮,其可有效改善患者临床症状,缩短神志转清时间,改善血清指标,值得临床应用。Objective To compare the clinical efficacy of flumazenil and naloxone in the treatment of hepatic coma.Methods A total of 74 patients with hepatic coma admitted to the Second Naval Hospital of Southern Theater Command from February 2019 to September 2021 were selected as the research objects.They were divided into flumazenil treatment group(38 cases)and naloxone treatment group(36 cases)by random number table method,and were treated with flumazenil and naloxone respectively.The total effective rate of clinical symptom improvement at 48 h of treatment,intelligence test timing(NCT,DS),consciousness clearance time,serum benzodiazepines(BZ)andβ-endorphin(β-EP)levels and 2-week survival rate were compared between the two groups.Results The total effective rate of clinical symptom improvement in flumazenil treatment group was 86.84%,which was higher than 66.67%in naloxone treatment group,and the difference was statistically significant(P<0.05).The duration of NCT and DS in flumazenil treatment group was shorter than that in naloxone treatment group,and the difference was statistically significant(P<0.05).After treatment,the level of BZ in the flumazenil group was lower than that in the naloxone group,and the level ofβ-EP was higher than that in the naloxone group,the difference was statistically significant(P<0.05).The 2-week survival rate of flumazenil treatment group was 76.32%,which was compared with 75.00%of naloxone treatment group,the difference was statistically significant(P>0.05).Conclusion The efficacy of flumazenil in the treatment of patients with hepatic coma is better than that of naloxone,which can effectively improve the clinical symptoms,shorten the time of consciousness recovery,and improve serum indicators.It is worthy of clinical application.

关 键 词：肝昏迷 氟马西尼 纳洛酮 Β-内啡肽 

分 类 号：R575[医药卫生—消化系统]