1例罕见盐酸纳美芬用药不良反应及治疗经验分享  

A case of rarely adverse drug reactions of Nalmefen hydrochloride and treatment experience sharing

作　　者：靳沙沙 何件根 田春艳 刘博 武亮 范维娇 JIN Shasha;HE Jiangen;TIAN Chunyan;LIU Bo;WU Liang;FAN Weijiao(Department of Sports Rehabilitation,Beijing Xiaotangshan Hospital,Beijing 102211,China)

机构地区：[1]北京小汤山医院运动康复科,102200

出　　处：《中国老年保健医学》2024年第1期138-140,共3页Chinese Journal of Geriatric Care

基　　金：北京市医院管理中心青年人才培养“青苗”计划“第五期”(编号:QML20192201)。

摘　　要：我院收治1例脊髓损伤合并顽固性神经病理性疼痛患者,缓慢滴注盐酸纳美芬(Nalmefene)注射液(规格:1ml:0.1mg)0.3mg溶于100ml氯化钠注射液静脉输液(30滴/分钟),输注约35ml左右时出现罕见过敏反应,主要表现为四肢湿冷、躁动、角弓反张、四肢震颤、胸腹部发紧痉挛、大声喊叫、强哭强笑、口面部及双手发红。患者出现症状后,立即停药,同时予心电监护、吸氧、大量补液、激素抗炎、镇静、利尿促排等综合治疗后逐渐好转,全程血压无降低,监测患者肝肾功能、心肌酶等均未见异常。本文结合患者病历资料分析了盐酸纳美芬的作用机制,及过敏后的全身反应及可能机制,分析了处置过程中的不足之处,同时完善科室内药物不良反应发生后的急救预案的制定,从而能及时有效救治、最大程度保证患者的安全,为临床脊髓损伤药物治疗提供一些思路。A 59-year-old male patient with spinal cord injury and intractable neuropathic pain slowly instilled 0.3mg of Nalmefene hydrochloride injection(Specification:1 ml:0.1 mg)dissolved in 100ml of sodium chloride injection for intravenous infusion(30 drops/min),and rare allergic reactions occurred when about 35ml was infused,mainly manifested as clammy and cold limbs,restlessness,angular arch reflexion,tremor of limbs,tightness and spasms of chest and abdomen,loud shouting,forced crying and laughter,redness of mouth,face and hands.After the onset of symptoms,the drug was stopped immediately,and at the same time,ECG monitoring,oxygen inhalation,large amount of fluids,hormone anti-inflammatory,sedation,diuretic stimulation and other comprehensive treatments gradually improved,and the blood pressure was not reduced throughout the whole process,and there was no abnormality in the monitoring of the patient's liver and kidney function and cardiac enzymes.For the first time,this paper comprehensively analyzed the mechanism of action of Nalmefene hydrochloride,the systemic reactions and possible mechanisms after allergies,analyzed the deficiencies in the treatment process,and improved the formulation of the emergency plan after the occurrence of adverse drug reactions in the department of the application of the drug,so as to provide timely and effective treatment,ensure the safety of the patient to the greatest extent,and provide some diagnosis and treatment ideas for the drug treatment of clinical spinal cord injury.

关 键 词：纳美芬 脊髓损伤 药物不良反应 

分 类 号：R969[医药卫生—药理学]