[1]李继荣,王志坚,李三清,等.氟马西尼及纳洛酮治疗肝昏迷的疗效比较[J].医学信息,2023,36(09):120-123.[doi:10.3969/j.issn.1006-1959.2023.09.024]
　LI Ji-rong,WANG Zhi-jian,LI San-qing,et al.Efficacy Comparison of Flumazenil and Naloxone in the Treatment of Hepatic Coma[J].Journal of Medical Information,2023,36(09):120-123.[doi:10.3969/j.issn.1006-1959.2023.09.024]
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氟马西尼及纳洛酮治疗肝昏迷的疗效比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年09期
页码:
120-123
栏目:
论著
出版日期:
2023-05-01

文章信息/Info

Title:
Efficacy Comparison of Flumazenil and Naloxone in the Treatment of Hepatic Coma
文章编号:
1006-1959（2023）09-0120-04
作者:
李继荣; 王志坚; 李三清; 等
（南部战区海军第二医院感染科1，血透中心2，海南 三亚 572000）
Author(s):
LI Ji-rong; WANG Zhi-jian; LI San-qing; et al.
(Department of Infectious Diseases1,Hemodialysis Center2,the Second Naval Hospital of Southern Theater Command,Sanya 572000,Hainan,China)
关键词:
肝昏迷; 氟马西尼; 纳洛酮; β-内啡肽
Keywords:
Hepatic coma; Flumazenil; Naloxone; β-endorphin
分类号:
R575
DOI:
10.3969/j.issn.1006-1959.2023.09.024
文献标志码:
A
摘要:
目的 比较氟马西尼及纳洛酮在肝昏迷治疗中的临床疗效。方法 选取2019年2月-2021年9月南部战区海军第二医院收治的74例肝昏迷患者作为研究对象，通过随机数字表法分为氟马西尼治疗组（38例）和纳洛酮治疗组（36例），分别给予氟马西尼和纳洛酮治疗。比较两组治疗48 h时临床症状改善总有效率、智力测验计时（NCT、DS）、神志转清时间、血清苯二氮卓（BZ）和β-内啡肽（β-EP）水平及2周后存活率。结果 氟马西尼治疗组临床症状改善总有效率为86.84%，高于纳洛酮治疗组的66.67%，差异有统计学意义（P＜0.05）；氟马西尼治疗组NCT、DS时长短于纳络酮治疗组，差异有统计学意义（P＜0.05）；氟马西尼组治疗后BZ水平低于纳洛酮组，β-EP水平高于纳洛酮组，差异有统计学意义（P＜0.05）；氟马西尼治疗组2周后存活率为76.32%，与纳洛酮治疗组的75.00%比较，差异无统计学意义（P＞0.05）。结论 氟马西尼治疗肝昏迷患者的疗效优于纳洛酮，其可有效改善患者临床症状，缩短神志转清时间，改善血清指标，值得临床应用。
Abstract:
Objective To compare the clinical efficacy of flumazenil and naloxone in the treatment of hepatic coma.Methods A total of 74 patients with hepatic coma admitted to the Second Naval Hospital of Southern Theater Command from February 2019 to September 2021 were selected as the research objects. They were divided into flumazenil treatment group (38 cases) and naloxone treatment group (36 cases) by random number table method, and were treated with flumazenil and naloxone respectively. The total effective rate of clinical symptom improvement at 48 h of treatment, intelligence test timing (NCT, DS), consciousness clearance time, serum benzodiazepines (BZ) and β-endorphin (β-EP) levels and 2-week survival rate were compared between the two groups.Results The total effective rate of clinical symptom improvement in flumazenil treatment group was 86.84%, which was higher than 66.67% in naloxone treatment group, and the difference was statistically significant (P<0.05). The duration of NCT and DS in flumazenil treatment group was shorter than that in naloxone treatment group, and the difference was statistically significant (P<0.05). After treatment, the level of BZ in the flumazenil group was lower than that in the naloxone group, and the level of β-EP was higher than that in the naloxone group, the difference was statistically significant (P<0.05). The 2-week survival rate of flumazenil treatment group was 76.32%, which was compared with 75.00% of naloxone treatment group, the difference was statistically significant (P>0.05).Conclusion The efficacy of flumazenil in the treatment of patients with hepatic coma is better than that of naloxone, which can effectively improve the clinical symptoms, shorten the time of consciousness recovery, and improve serum indicators. It is worthy of clinical application.

参考文献/References:

[1]Weissenborn K.Hepatic Encephalopathy:Definition,Clinical Grading and Diagnostic Principles[J].Drugs,2019,79(Suppl 1):5-9. [2]Rose CF,Amodio P,Bajaj JS,et al.Hepatic encephalopathy:Novelinsights into classification, pathophysiology and therapy[J].J Hepatol,2020,73(6):1526-1547.[3]张艳丽,侯传强.门冬氨酸鸟氨酸联合氟马西尼治疗肝性脑病的疗效观察[J].现代消化及介入诊疗,2011,16(4):242-244.[4]Liotta EM,Romanova AL,Lizza BD,et al.Osmotic Shifts, Cerebral Edema, and Neurologic Deterioration in Severe Hepatic Encephalopathy[J].Crit Care Med,2018,46(2):280-289.[5]陆德云,温彪,何峰.纳洛酮治疗肝性脑病的临床疗效观察[J].临床和实验医学杂志,2012,11(9):703-705.[6]中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见(2013年,重庆)[J].中华肝脏病杂志,2013,21(9):641-651.[7]Gow AG.Hepatic Encephalopathy[J].Vet Clin North Am Small Anim Pract,2017,47(3):585-599.[8]徐小元,丁惠国,李文刚,等.肝硬化肝性脑病诊疗指南[J].临床肝胆病杂志,2018,34(10):2076-2089.[9]Sivolap YP.Prevention and treatment of hepatic encephalopathy[J].Zh Nevrol Psikhiatr Im S S Korsakova,2017,117(10):144-147. [10]H?覿ussinger D,Butz M,Schnitzler A,et al.Pathomechanisms in hepatic encephalopathy[J].Biol Chem,2021,402(9):1087-1102.[11]Butterworth RF.Hepatic Encephalopathy in Cirrhosis:Pathology and athophysiology[J].Drugs,2019,79(Suppl 1):17-21. [12]Hadjihambi A,Arias N,Sheikh M,et al.Hepatic encephalopathy:a critical current review[J].Hepatol Int,2018,12(Suppl 1):135-147. [13]Said VJ,Garcia-Trujillo E.Beyond Lactulose:Treatment Options for Hepatic Encephalopathy[J].Gastroenterol Nurs,2019,42(3):277-285.[14]Jaffe A,Lim JK,Jakab SS.Pathophysiology of Hepatic Encephalopathy[J].Clin Liver Dis,2020,24(2):175-188. [15]Fiati Kenston SS,Song X,Li Z,et al.Mechanistic insight,diagnosis,and treatment of ammonia-induced hepatic encephalopathy[J].J Gastroenterol Hepatol,2019,34(1):31-39.[16]Jiang Q,Jiang G,Welty TE,et al.Naloxone in the management of hepatic encephalopathy[J].J Clin Pharm Ther,2019,35:333-341.[17]Alimirah M,Sadiq O,Gordon SC.Novel Therapies in Hepatic Encephalopathy[J].Clin Liver Dis,2020,24(2):303-315. [18]Al-Halawani M,Sen P,Abdeen Y,et al.Continuous intravenous flumazenil infusion in a patient with chlordiazepoxide toxicity and hepatic encephalopathy[J].J Emerg Trauma Shock,2015,8(1):58-60.[19]Agrawal A,Diez A,Bajaj D.Role of Flumazenil in the Management of Hepatic Encephalopathy[J].Am J Ther,2020,27(6):e629-e630.[20]Goh ET,Andersen ML,Morgan MY,et al.Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy[J].Cochrane Database Syst Rev,2017,7(7):371-376.

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更新日期/Last Update: 1900-01-01