陈喜彬 李少杰 苏志强

【摘要】 目的：分析纳洛酮联合醒脑静治疗急性重度酒精中毒患者的效果及安全性。方法：选取2017年9月-2018年10月笔者所在医院收治的急性酒精中毒患者160例，采用随机数表法分为对照组和观察组，每组80例，分别采用纳洛酮和纳洛酮联合醒脑静治疗。观察两组临床疗效、症状恢复情况及脏器功能恢复等指标。结果：两组治疗总有效率分别为92.50%和77.50%，观察组显著高于对照组，差异有统计学意义（P<0.05）。观察组意识、语言、运动恢复时间均显著早于对照组，差异有统计学意义（P<0.05）。两组治疗1 d后血清肌酸激酶、谷丙转氨酶、谷草转氨酶水平对比，差异均无统计学意义（P>0.05）。结论：纳洛酮联合醒脑静可以显著提升急性重度酒精中毒治疗有效率，缩短意识、语言、运动恢复时间，可以在急性重度酒精中毒治疗中推广使用。

【关键词】 纳洛酮 醒脑静 急性重度酒精中毒 临床疗效 脏器功能

doi：10.14033/j.cnki.cfmr.2019.29.063 文献标识码 B 文章编号 1674-6805（2019）29-0-03

[Abstract] Objective： To analyze the efficacy and safety of Naloxone combined with Xingnaojing in the treatment of acute severe alcoholism. Method： From September 2017 to October 2018， 160 patients with acute alcoholism admitted to our hospital were divided into the control group and the observation group by random number table method， 80 cases in each group. Naloxone and Naloxone combined with Xingnaojing were used respectively. The clinical efficacy， symptoms recovery and organ function recovery of the two groups were observed. Result： The total effective rates of the two groups were 92.50% and 77.50%， respectively. The observation group was significantly higher than the control group， with statistical significance （P<0.05）. The recovery time of consciousness， language and movement in the observation group was significantly earlier than that in the control group， with statistical significance （P<0.05）. There was no significant difference in serum creatine kinase， alanine aminotransferase and glutamic oxalate aminotransferase levels between the two groups after 1 day of treatment （P>0.05）. Conclusion： Naloxone combined with Xingnaojing can significantly improve the treatment efficiency of acute severe alcoholism， shorten the recovery time of consciousness， language and movement， and can be widely used in the treatment of acute severe alcoholism.

[Key words] Naloxone Xingnaojing Acute severe alcoholism Clinical efficacy Organ function

First-authors address： Fifth Affiliated Hospital of Sun Yat-sen University， Zhuhai 519000， China

急性酒精中毒是常見的内科急、重症，是指一次大量摄入酒精（乙醇）后出现的脏器功能异常，常以神经系统和肝脏系统症状最为显著，重度中毒常威胁生命[1]。急性重度酒精中毒常发生在饮酒量450 ml以上时，患者常呈昏睡或昏迷状态，常伴呼吸抑制、发绀、血压下降、大小便失禁等症状，可在短时间内诱发死亡[2]。纳洛酮是阿片类受体特异性拮抗剂，可对抗内源性β-内啡肽，可以防止和逆转酒精中毒，起到促醒、恢复中枢系统功能等作用[3]。醒脑静注射液由安宫牛黄丸改制而成的中药制剂，具有镇静、开窍、醒脑、安神等作用，有利于酒精中毒患者的恢复[4]。笔者所在医院对2017年9月-2018年10月收治的急性酒精中毒患者给予纳洛酮联合醒脑静治疗，取得显著成果，现将结果报告如下。……