目的 探讨纳络酮在院前急救酒精时毒中的应用效果及其对患者预后的影响.方法 选取2016年1月至2017年4月院前急救的74例急性酒精中毒患者作为观察对象,采取随机数字表将其分成两组,每组各37例.两组患者均给予常规院前急救,观察组在院前急救过程中联合给予纳洛酮治疗,比较两组患者的转归时间、动脉血气分析、血清β-内啡肽水平变化情况,同时统计两组不良反应发生情况.结果 观察组有效、显效、治愈时间均较对照组有显著缩短(P<0.01).观察组治疗后1h pH值、动脉血气分压(PaO2)、氧饱和度(SaO2)水平显著高于对照组,二氧化碳分压(PaCO2)水平显著低于对照组(P<0.01).两组治疗后1h、2h血清β-内啡肽水平逐渐降低,且均显著低于治疗前(P<0.01),治疗后1h、2h观察组血清β-内啡肽水平显著低于对照组同时点(P<0.01).两组不良反应发生率比较差异无统计学意义(P>0.05).结论 将纳洛酮用于急性酒精中毒患者的院前急救中能有效提高急救效果,改善患者预后.%Objective To investigate the effect of naloxone in pre-hospital emergency alcohol intoxication and its effect on prognosis. Methods 74 cases of acute alcoholism patients conducted pre-hospital care by our hospital from January 2016 to April 2017 were selected as the research objects,and divided into two groups by random number table,37 cases in each. Two groups of patients were given routine pre-hospital care,and the observation group was combined with naloxone in the pre-hospital care process. Then the time of clinical outcome,arterial blood gas analysis and the changes of serum levels of β - endorphin were compared between the two groups. Meanwhile,the adverse reactions of the two groups were recorded. Results The effective,significantly effective and cure time of the observation group were significantly shorter than those of the control group(P<0.01). The levels of PH,PaO2 and SaO2 in the observation group after 1h of the treatment were significantly higher than those in the control group,and the level of PaCO2 was significantly lower than that of the control group(P<0.01). Serum levels of β-endorphin decreased gradually after 1,2h of the treatment in the two groups,both of which were significantly lower than those before the treatment(P<0.01). And the level of serumβ-endorphin the observation group was lower than that in control group of the same time period(P<0.01). There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Naloxone in the application of acute alcoholism can effectively improve the efficacy of pre-hospital first aid and improve the prognosis of patients.
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