中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
8期
1210-1214
,共5页
单鸿伟%崔晓迎%牛君义%张红梅%赵王磊%陈凤英
單鴻偉%崔曉迎%牛君義%張紅梅%趙王磊%陳鳳英
단홍위%최효영%우군의%장홍매%조왕뢰%진봉영
氯氮平中毒%血液灌流%纳洛酮
氯氮平中毒%血液灌流%納洛酮
록담평중독%혈액관류%납락동
Clozapine poisoning%Hemoperfusion%Naloxone
目的 探讨血液灌流和纳洛酮治疗氯氮平中毒的临床效果.方法 将内蒙古医科大学附属医院2007年8月至2014年4月救治的41例急性氯氮平中毒患者据治疗方式不同分为常规治疗组(20例)、血液灌流和纳洛酮治疗组(21例).常规治疗组患者入院后给予洗胃、利尿、导泻、保护脏器功能等治疗,血液灌流和纳洛酮治疗组患者在上述常规治疗基础上,用HA230灌流器以150 ～ 200 ml/min流速血液灌流2h,血液灌流后在4h内静脉滴注纳洛酮0.5 mg/kg.观察并比较2组患者治疗5d后病死率、昏迷时间和并发症发生率.结果 常规治疗组和血液灌流和纳洛酮治疗组病死率分别为10.0％ (2/20)和4.7％(1/21),组间差异无统计学意义(P＞0.05);昏迷时间分别为(30±14)h和(19±10)h,组间差异有统计学意义(P＜0.05).常规治疗组中有8例患者(44.4％)出现吸入性肺炎,血液灌流和纳洛酮组中仅有1例(6.2％)出现吸入性肺炎,组间差异有统计学意义(P＜0.05).血液灌流和纳洛酮组和常规治疗组其他并发症如肝功能异常、心肌酶学异常、心功能不全、低血压、癫(痫)发作、深静脉穿刺部位出血、血小板减少发生率,差异均无统计学意义[19.0％(4/21)比25.0％(5/20),38.1％(8/21)比35.0％(7/20),19.0％(4/21)比15.0％(3/20),23.8％ (5/21)比10.0％(2/20),9.5％(2/21)比10.0％(2/20),23.8％ (5/21)比0.0,9.5％(2/21)比0.0](均P＞0.05).结论 血液灌流和纳洛酮联合治疗可缩短氯氮平中毒患者昏迷时间,降低吸入性肺炎并发症发生率.
目的 探討血液灌流和納洛酮治療氯氮平中毒的臨床效果.方法 將內矇古醫科大學附屬醫院2007年8月至2014年4月救治的41例急性氯氮平中毒患者據治療方式不同分為常規治療組(20例)、血液灌流和納洛酮治療組(21例).常規治療組患者入院後給予洗胃、利尿、導瀉、保護髒器功能等治療,血液灌流和納洛酮治療組患者在上述常規治療基礎上,用HA230灌流器以150 ～ 200 ml/min流速血液灌流2h,血液灌流後在4h內靜脈滴註納洛酮0.5 mg/kg.觀察併比較2組患者治療5d後病死率、昏迷時間和併髮癥髮生率.結果 常規治療組和血液灌流和納洛酮治療組病死率分彆為10.0％ (2/20)和4.7％(1/21),組間差異無統計學意義(P＞0.05);昏迷時間分彆為(30±14)h和(19±10)h,組間差異有統計學意義(P＜0.05).常規治療組中有8例患者(44.4％)齣現吸入性肺炎,血液灌流和納洛酮組中僅有1例(6.2％)齣現吸入性肺炎,組間差異有統計學意義(P＜0.05).血液灌流和納洛酮組和常規治療組其他併髮癥如肝功能異常、心肌酶學異常、心功能不全、低血壓、癲(癇)髮作、深靜脈穿刺部位齣血、血小闆減少髮生率,差異均無統計學意義[19.0％(4/21)比25.0％(5/20),38.1％(8/21)比35.0％(7/20),19.0％(4/21)比15.0％(3/20),23.8％ (5/21)比10.0％(2/20),9.5％(2/21)比10.0％(2/20),23.8％ (5/21)比0.0,9.5％(2/21)比0.0](均P＞0.05).結論 血液灌流和納洛酮聯閤治療可縮短氯氮平中毒患者昏迷時間,降低吸入性肺炎併髮癥髮生率.
목적 탐토혈액관류화납락동치료록담평중독적림상효과.방법 장내몽고의과대학부속의원2007년8월지2014년4월구치적41례급성록담평중독환자거치료방식불동분위상규치료조(20례)、혈액관류화납락동치료조(21례).상규치료조환자입원후급여세위、이뇨、도사、보호장기공능등치료,혈액관류화납락동치료조환자재상술상규치료기출상,용HA230관류기이150 ～ 200 ml/min류속혈액관류2h,혈액관류후재4h내정맥적주납락동0.5 mg/kg.관찰병비교2조환자치료5d후병사솔、혼미시간화병발증발생솔.결과 상규치료조화혈액관류화납락동치료조병사솔분별위10.0％ (2/20)화4.7％(1/21),조간차이무통계학의의(P＞0.05);혼미시간분별위(30±14)h화(19±10)h,조간차이유통계학의의(P＜0.05).상규치료조중유8례환자(44.4％)출현흡입성폐염,혈액관류화납락동조중부유1례(6.2％)출현흡입성폐염,조간차이유통계학의의(P＜0.05).혈액관류화납락동조화상규치료조기타병발증여간공능이상、심기매학이상、심공능불전、저혈압、전(간)발작、심정맥천자부위출혈、혈소판감소발생솔,차이균무통계학의의[19.0％(4/21)비25.0％(5/20),38.1％(8/21)비35.0％(7/20),19.0％(4/21)비15.0％(3/20),23.8％ (5/21)비10.0％(2/20),9.5％(2/21)비10.0％(2/20),23.8％ (5/21)비0.0,9.5％(2/21)비0.0](균P＞0.05).결론 혈액관류화납락동연합치료가축단록담평중독환자혼미시간,강저흡입성폐염병발증발생솔.
Objective To discuss the curative effect of hemoperfusion and naloxone in the treatment of clozapine poisoning.Methods Totally 34 patients with clozapine poisoning from August 2008 to April 2014 were divided into two groups.There were 20 patients in the routine treatment group and 21 patients in the hemoperfusion and naloxone treatment group.The patients were treated with gastric lavage,dieresis,catharsis and protection of liver function in the routine treatment group.The patients of hemoperfusion and naloxone treatment group had hemoperfusion,HA230 and naloxone after routine treatment.The mortality,coma time and the complication of aspiration pneumonia in the two groups before treatment and after 5 days were observed and analyzed.Results The mortalities of two groups were 10.0％ (2/20) in the routine treatment group and 4.7％ (1/21) in the hemoperfusion and naloxone treatment group(P ＞ 0.05).The average coma time of two groups was (30 ± 14)h in the routine treatment group and (19 ± 10) h in the hemoperfusion and naloxone treatment group (P ＜ 0.05).8 patients (44.4％) had aspiration pneumonia in the routine treatment group,but only 1 patient(6.2％) had it in the hemoperfusion and naloxone treatment group(P ＜0.05).Coma time and the complication of aspiration pneumonia in the hemoperfusion and naloxone treatment group were significantly lower than those in the routine treatment group (P ＜ 0.05).There were no statistically significant differences in the incidence rate of other complications such as the abnormal liver function,myocardial enzymology,cardiac insufficiency,low blood pressure,seizures,deep vein puncture bleeding and thrombocytopenia,between blood perfusion and naloxone group and conventional treatment group [19.0 ％ (4/21) vs 25.0％ (5/20),38.1％ (8/21) vs 35.0％ (7/20),19.0％ (4/21) vs 15.0％ (3/20),23.8％ (5/21) vs 10.0％ (2/20),9.5％ (2/21) vs 10.0％ (2/20),23.8％ (5/21) vs 0.0,9.5％ (2/21) vs 0.0] (all P ＞ 0.05).Conclusion Hemoperfusion combined with naloxone in the treatment of patients clozapine poisoning can decrease the coma time and the complication of aspiration pneumonia.
