| Background and objectiveAcute alcohol intoxication is one of emergency common disease, severe poisoning and even threaten the life of patients for further study of acute severe alcoholism:clinical drug therapy methods and curative effect. Hydrochloric acid accept nalmefene become in the treatment of acute severe alcoholism another drug, understand the nalmefene and naloxone in the treatment of acute severe alcoholism different clinical effect, the analysis method of the drug use and the use of the difference. The clinical effect of hemodialysis and promote wake agent between the comparison of curative effect, which is more suitable for clinical application put forward new problems.Materials and methodsThe first affiliated hospital of zhengzhou university school of medicine and zhoukou city hospital emergency department selection from June2011to April2012for alcohol poisoning cause coma patients with severe75cases, carries on the emergency treatment of outpatient drug curative effect observation. The research object, all choose18～48years men. Drinking height liquor300ml to700ml, for more than2hours after admission. Patients before drinking without taking antibiotics history, no basic diseases, patients admission are coma. GCS<8,Failed to gastric lavage, at the same time CT ruled out intracranial disease.later in ECG and refers to the pulse oxygen monitoring of treatment. Will the75cases of acute severe alcoholism patients divided into three groups, according to the category of treatment, as I treatment group (nalmefene group), treatment group Ⅱ (hemodialysis group) and normal group (naloxone group). The treatment group Ⅰ (nalmefene group):to nalmefene0.2mg+NS20ml intravenous push note, then nalmefene0.2mg+NS250ml intravenous drip. At the same time to conventional composite water soluble vitamins,5%GS2000ml. The treatment group Ⅱ application’s nalmefene treatment on the basis of drug hemodialysis, blood flow200ml/min, dialysis time2.5hours. And conventional group (naloxone group):to give naloxone0.8mg+NS20ml intravenous push note, then give naloxone1.2mg+NS250ml intravenous drip. Conventional give composite water soluble vitamins,5%GS2000ml. The patients were observed45min,90min,150min to mind consciousness recovery. Invalid: GCS<8,moderate coma, no reaction to pain, double pupilary light slow response or disappear, no pathological reflex. Effective:8<GCS<12coma to shallow coma, strong stimulation can open your eyes, the pain has positioning. Pupilary light reflex sensitive. Remarkable curative effect:GCS>12sleepiness, wake up, wake up can answer this question. He can express meaning. Finally the summarized data SPSS V13.0statistical analysis, ues χ2test method, p<0.05for difference. Draw the following conclusion.ResultsThe total effective rate comparison treatment45min in nalmefene group is better than that of naloxone group, there are difference (p<0.05, table3), and hemodialysis group is better than that of naloxone group, there are difference (p<0.05); Hemodialysis combination nalmefene group is no difference (p>0.05), the total effective rate in the treatment of90min nalmefene group is better than that of naloxone group, there are difference (p<0.05), the hemodialysis group was better than naloxone group, there were significant differences (p<0.012), hemodialysis group and accept nalmefene group is no difference (p>0.01), the treatment of150min nalmefene group is better than that of naloxone group, there are difference (p<0.05) hemodialysis group was better than naloxone group, there were significant differences (p<0.01), the hemodialysis group and accept nalmefene group is no difference (p>0.05).In the significant efficiency comparison treatment45min three groups of comparisons nalmefene group and naloxone group and blood dialysis group, were no difference (p>0.05), the treatment90min show efficiency nalmefene group is obviously superior to the naloxone group, there were significant differences (p< 0.01), the hemodialysis group was better than naloxone group, there were significant differences (p<0.01), and hemodialysis group and accept nalmefene group is no significant differences (p>0.05), the treatment of150min nalmefene group is better than that of naloxone group, there are difference (p<0.05) hemodialysis group was better than naloxone group, there were significant differences (p<0.01), the hemodialysis group is superior to accept nalmefene, groups of comparisons has difference (p<0.05).As for the comparison of the viscera function recovery effect of three groups of patients under different treatment, there was no significant difference (P>0.05). The indicators are as follows, Creatine Kinase(CK)、Alanine transaminase (ALT) and Aspartate Transaminase (AST)ConclusionIn acute alcohol intoxication, nalmefene to promote wake effect is better than that of naloxone. And fewer side effects, and basic clinical physicians promotion. Hemodialysis technology is in the total effective rate and nalmefene is no special advantages, but show high efficiency, patients coma time is short, less complications and sequelae shape, it’s worth acute severe alcoholism patients early use. |
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