纳洛酮辅助治疗老年肺性脑病的临床观察  

Clinical Observation on Efficacy of Naloxone (Jinerlun) in its Auxiliary Treatment of Senile Pulmonary Encephalopaphy

作　　者：曹素艳[1] 王蓓[1] 姜宏志[1] 

机构地区：[1]卫生部北京医院急诊科,北京100730

出　　处：《医学临床研究》2003年第9期674-675,678,共3页Journal of Clinical Research

摘　　要：目的观察总结纳洛酮在辅助治疗老年肺性脑病的作用 ,探讨其疗效及安全性。方法5 2例老年肺性脑病患者 ,随机分为纳洛酮组和常规治疗组 ,每组中又根据病情分别分为嗜睡组及浅昏迷组、深昏迷组。对比分析各组神志清醒所需时间、神志转清率、机械通气率及病死率 ,同时比较神清前后PaO2 、PaCO2值。结果纳洛酮组与常规治疗组比较 ,神志转清所需时间短 ,神志转清率高 (P <0 .0 5 )。浅昏迷患者中纳洛酮组机械通气率、病死率较常规治疗组低 (P <0 .0 5 ) ;但深昏迷患者两组相比差异无显著性。纳洛酮组与常规治疗组患者清醒前后PaO2 、PaCO2 变化差异无显著性。使用纳洛酮后未见明显不良反应。结论纳洛酮对老年肺性脑病昏迷具有一定的促醒作用且安全性高 ,尤其对轻。ObjectivesTo observe the effect of naloxone as the auxiliary remedy in treatment of senile pulmonary encephalopaphy (SPE) and explore its therapeutic efficacy and safety.MethodsFifty two patients with SPE were randomly divided into 2 groups:①Control group (routine therapy,n=21) and ②Naloxone group(routine therapy plus naloxone,n=31).Two groups were further divided into 2 subgroups: subgroup A(in lethargy or semicoma) and subgroup B(in deep coma).The time required to restore consciousness, rate of reconsciousness , rate of mechanical ventilation and mortality were analyzed between both groups. The results of PaO 2 and PaCO 2 before and after consciousness were also compared.ResultsThe Naloxone group required relatively short time to restore consciousness and manifested high rate of reconsciousness as compared with the control group (P<0.05).The rate of mechanical ventilation and mortality in subgroup A were considerably lower than those in control group (P<0.05), but there was no significant difference in these two indices between two subgroups.A comparison of PaO 2 and PaCO 2 before and after consciousness between control and naloxone groups revealed no difference. Adverse reaction was not found following naloxone administration.ConclusionNaloxone is characterized by its high safety and can exert certain awakening effect for SPE patients with coma. It will be more effective in mild and moderate severe SPE patients if they are treated earlier.

关 键 词：纳洛酮 辅助治疗 肺性脑病 老年人 并发症 药物疗法 

分 类 号：R563[医药卫生—呼吸系统] R742[医药卫生—内科学]