纳洛酮辅助治疗急性酒精中毒的临床疗效观察

目的:观察纳洛酮(naloxone,NLX)辅助治疗急性酒精中毒(acute alcohol intoxication,AAI)的临床疗效,探讨提高急性酒精中毒急诊救治水平的有效措施。方法:选择同期内急诊治疗的60例AAI患者,在患者家属知情同意的情况下将以上患者均分为对照组(n=30例)和观察组(n=30例),对照组患者施行常规的急诊治疗措施,观察组患者在常规急诊治疗措施基础上加行NLX治疗,比较两组患者治疗后的平均有效时间、平均显效时间、平均治愈时间和不良反应的发生情况。结果:两组中兴奋期和共济失调期患者平均有效时间、平均显效时间和平均治愈时间比较,差异具有统计学意义(P<0.05);昏迷期患者平均有效时间、平均显效时间和平均治愈时间比较,差异具有显著统计学意义(P<0.01),观察组均优于对照组。两组患者不良反应的发生率比较,差异无统计学意义(P>0.05),且发生不良反应的患者症状轻微,无需特殊处理即可缓解。结论:在AAI患者的急诊治疗过程中,特别是对较重的AAI患者,加用NLX辅助治疗可显著缩短患者的临床转归时间,且安全可靠。     

依达拉奉联合醒脑静治疗急性脑出血的临床疗效观察

目的:探究依达拉奉联合醒脑静治疗急性脑出血(ACH)的临床疗效及对炎症指标的影响。方法:本研究于2013年2月~2015年2月期间,选择我院收治的ACH患者128例为研究对象,采用随机数字法将其分为研究组(65例)和对照组(63例)。两组患者均给予一般常规治疗并给予依达拉奉,研究组患者在此基础上联用醒脑静注射液治疗。观察两组患者治疗前后炎症因子变化、采用美国国立卫生研究院的卒中量表(NIHSS)评价神经功能缺损修复情况、采用格拉斯哥昏迷评分(GCS)评价患者意识状态,并对比治疗后临床疗效。结果:治疗后两组患者C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平和NIHSS评分均出现明显降低(均P0.05),GCS评分均出现明显升高(P0.05),且研究组上述指标改善均优于对照组,差异均存在统计学差异(均P0.05);治疗后研究组有效率为87.69%,显著高于对照组的69.84%(X2=6.125,P=0.013)。结论:依达拉奉联合醒脑静治疗ACH,能够改善患者神经功能损伤及炎症反应,预后好,疗效确切,具有重要的临床价值。     

纳洛酮与氨茶碱联合治疗小儿急性呼吸衰竭的疗效分析

目的观察纳洛酮联合氨茶碱治疗小儿急性呼吸衰竭的临床效效。方法选择2014年10月~2017年2月我院收治的急性呼吸衰竭患儿97例作为研究对象,按随机数字原则分为对照组和观察组,两组患儿均行常规对症急救措施,在此基础上对照组给予氨茶碱辅助治疗,观察组给予纳洛酮联合氨茶碱治疗,观察比较两组临床治疗效果。结果观察组患儿的临床疗效明显优于对照组,而且观察组用药后呼吸困难、发绀、节律紊乱发生率明显低于对照组,两组比较差异均有统计学意义(均P0.05)。结论纳洛酮联合氨茶碱治疗小儿急性呼吸衰竭的临床疗效显著,症状体征改善明显,具有较高的临床应用价值。     

纳洛酮治疗急性酒精中毒39例分析

急性酒精中毒主要表现在中枢神经系统抑制。盐酸纳洛酮作为阿片受体拮抗剂，治疗急性酒精中毒效果显著。     

纳洛酮联合复方麝香注射液治疗急性酒精中毒128例疗效观察

目的观察复方麝香注射液联合纳洛酮治疗重度酒精中毒的临床疗效。方法将128例急性酒精中毒患者随机分为治疗组和对照组,治疗组66例,采用复方麝香注射液联合纳洛酮治疗;对照组62例,单纯采用纳洛酮治疗,并观察比较两组患者的清醒时间,症状缓解时间和不良反应情况。结果治疗组在恢复清醒时间,头痛头晕、恶心呕吐症状缓解时间,烦躁控制时间等方面均优于对照组(P0.001)。结论复方麝香注射液联合纳洛酮治疗急性酒精中毒疗效明显。     

醒脑静注射液联合纳洛酮治疗急性酒精中毒24例

随着人们生活水平的不断提高,饮食结构的改变,饮酒人数的增多,因而酒精中毒者也日益增多。我院神经内科应用醒脑静注射液联合纳洛酮治疗急性酒精中毒24例,取得一定疗效,现报道如下。     

醒脑静联合纳洛酮对急性脑出血伴意识障碍患者神经功能、炎性因子和氧化应激的影响

摘要 目的：探讨纳洛酮联合醒脑静对急性脑出血（ACH）伴意识障碍患者炎性因子、神经功能和氧化应激的影响。方法：选取2017年2月~2019年12月期间我院收治的95例ACH伴意识障碍患者,按照随机数字表法将上述患者分为对照组（n=47）和研究组（n=48）,对照组患者予以纳洛酮治疗,研究组则在对照组的基础上联合醒脑静治疗,比较两组患者疗效、神经功能、炎性因子和氧化应激指标,记录两组不良反应发生情况。结果：研究组治疗10 d后的临床总有效率为91.67%（44/48）,高于对照组的74.47%（35/47）（P<0.05）。两组治疗10 d后美国国立卫生研究院卒中量表（NIHSS）评分,白介素-6（IL-6）、C反应蛋白（CRP）以及肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）水平均较治疗前下降,且研究组低于对照组（P<0.05）。两组治疗10 d后超氧歧化酶 (SOD)水平均较治疗前升高,且研究组高于对照组（P<0.05）。两组不良反应发生率对比未见统计学差异（P>0.05）。结论：醒脑静联合纳洛酮治疗ACH伴意识障碍患者,疗效显著,可有效改善患者神经功能、炎性因子和氧化应激,且安全性较好。     

氨茶碱联合纳洛酮治疗早产儿原发性呼吸暂停疗效观察

目的 观察氨茶碱联合纳洛酮治疗早产儿原发性呼吸暂停的疗效.方法 60例原发性呼吸暂停早产儿随机分为两组,在常规治疗基础上,两组均应用氨茶碱,首剂5 mg/kg,12 h后给予维持量2.5 mg/kg,每12 h给药1次;治疗组加用纳洛酮10 μg/(kg·h),每8h或12 h给药1次.结果 治疗组总有效率为93.3％,对照组总有效率为70.0％.两组总有效率比较差异有统计学意义(x2=4.01,P＜0.05).结论 氨茶碱与纳洛酮联合应用优于单纯用氨茶碱治疗早产儿原发性呼吸暂停.     

盐酸纳洛酮治疗意识障碍的临床疗效观察

近来,纳洛酮在临床上应用日渐广泛,尤其在抢救危急重症患者中证实有较好的促进昏迷苏醒,解除呼吸、循环抑制的作用,已成为急救中的万能药物.     

尼莫地平治疗高血压性脑出血疗效观察

目的:尼莫地平治疗高血压性脑出血的临床疗效。方法:90例高血压脑出血患者随机分为实验组(45例)和对照组(45例),对照组仅采用常规治疗,实验组在常规治疗的基础上采用尼莫地平进行治疗,比较两组临床疗效、治疗前后的临床神经功能缺损评分、临床残疾评分以及血肿和水肿带体积改变。结果:实验组和对照组的治疗有效率为73.33%和42.22%,差异具有统计学意义(P<0.05)。实验组和对照组治疗前、后临床神经功能缺损评分分别为(18.58±3.06)、(12.31±2.74)和(18.28±2.97)、(15.22±2.72),实验组和对照组治疗前、后临床残疾评分分别为(38.93±3.37)、(61.57±3.03)和(37.51±4.962)和(43.48±7.19),实验组和对照组治疗前、后的血肿体积分别为(17.23±5.48)cm3、(7.93±3.33)cm3和(17.60±5.46)cm3、(10.97±4.25)cm3,实验组和对照组治疗前、后的水肿带体积分别为(7.73±3.20)cm3、(4.21±1.60)cm3和(7.83±3.19)cm3和(5.67±1.82)cm3,所有患者治疗后各指标均优于治疗前,治疗后两组组间比较均有有显著性(P<0.01)。结论:尼莫地平能够明显的减少血肿体积和水肿带的体积,提高治疗的效果,减少脑出血患者发生神经功能缺损和残疾的可能。     

应用锥颅置管引流手术治疗急性高血压脑出血

探讨应用锥颅置管引流术治疗急性高血压脑出血的临床治疗效果。方法：对62例应用锥颅置管引流术治疗的高血压脑出血病人进行了回顾性分析。对高血压脑出血的全组病例的发病年龄、性别、诱发病因、病史、常见发病部位、类型、手术方式以及临床效果进行了分析。结果：手术后2—6个月,按COS方法判定病人治疗效果。手术治疗结果：全组有痊愈者20例,中残者23例,重残者9例,植物生存者4例,死亡者6例（死亡率为10％）。结论：锥颅置管引流的手术方式,安全、医疗费用非常低廉,而且该手术后并发症和死亡率均降低。加之它简便,疗效确切,故值得临床广泛推广应用。     

丁苯酞氯化钠注射液治疗急性脑梗死临床疗效观察

目的观察丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法将124例急性脑梗死患者随机分为治疗组和对照组各62例,对照组给予常规治疗,治疗组在常规治疗基础上加用丁苯酞氯化钠注射液治疗,观察比较两组的临床疗效、神经功能缺损评分(NIHSS)和日常生活能力(ADL)。结果治疗组的总有效率为96.8%,明显高于对照组的80.6%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者的NIHSS评分均低于治疗前,ADL评分高于治疗前,差异均有统计学意义(均P0.05);而且两组患者的NIHSS评分、ADL评分比较,治疗组改善明显优于对照组,差异均有统计学意义(均P0.05)。结论丁苯酞氯化钠注射液治疗急性脑梗死能明显提高临床疗效,改善患者的神经功能,提高日常生活能力。     

Brain stem insufficiency in acute ischemia and cerebral hemorrhage]

Consciousness disorders are closely related to the general dysfunction of the brain stem, and called by some authors brain stem insufficiency. To evaluate the degree of brain stem dysfunction, an original scale has been elaborated. Each group of brain stem functions are scored. Consciousness being the most important symptom of the brain stem insufficiency is scored about 50% in a 63-score scale. Scores are used to achieve the most objectivity in the clinical monitoring of the brain stem insufficiency. Its utility was examined in 75 patients with either ischemia or cerebral hemorrhage. Patients of both groups with severe insufficiency below 33 scores and persisting over 24 hours had no chance to survive. The authors suggest that the scores may successfully be used in the clinical monitoring of all disorders producing consciousness disturbances. Survival of patients with brain stem insufficiency in the course of cerebral ischemia or hemorrhage depends on the degree and duration of the brain stem insufficiency.     

The efficacy of diazepam in the treatment of acute iron overload in rats

While conducting studies on the prevention of mortality from acute iron intoxication in rats, diazepam, given to prevent animal suffering, was observed to be associated with reduced mortality in a limited number of animals. The objective was to assess whether diazepam reduces mortality following acute iron intoxication in rats. Survival of rats was compared among groups receiving (i) orally 612 mg/kg iron alone (LD60), (ii) iron with a subcutaneous injection of 2.5 mg/kg diazepam (DZ), or (iii) iron, DZ with 800 mg/kg deferiprone intraperitoneal injections. The administration of DZ decreased mortality from 60 to 16% (p < 0.001). The addition of deferiprone to DZ resulted in zero mortality (p < 0.05 compared with the DZ group) over the study period. The administration of DZ was not associated with decreased iron absorption or increased urinary iron excretion, whereas the administration of deferiprone did result in urinary iron excretion. Microscopic examination suggests that diazepam administration may be associated with lower intracellular accumulation of iron. In conclusion, diazepam reduces mortality from iron overdose in rats through a yet unidentified mechanism, although the drug does not inhibit iron absorption or enhance urinary iron removal.     

The evaluation of the efficacy of antihypoxic agents lowering hemoglobin oxygen affinity in acute cerebral ischemia]

Influence of natrii hydroxybutyrate (100 mg/kg), ascorbate (100 mg/kg), cavinton (5 mg/kg), bemitil (50 mg/kg), ethomersol (50 mg/kg) on Hb-O2 affinity and cortex PO2 after both carotid artery occlusion in rats was investigated. Correlation (r-0.87; P less than 0.05) between lowering of Hb-O2 affinity and antihypoxic effect was demonstrated in the line of these drugs.     

Effects of mouse nerve growth factor in treating cerebral injury in acute period caused by cerebral hemorrhage

ObjectiveTo explore the clinical effects of mouse Nerve Growth Factor (NGF) in treating cerebral injury in acute period caused by cerebral hemorrhage, observe its influences on Natriuretic Peptide (BNP) and NF-kB Level and evaluate its safety and efficiency.Methods96 cases with acute cerebral hemorrhage from January 2016 to January 2017 in our hospital were recruited as this study, they were randomly divided into the control group and the observation group, each 48 cases. The observation group were given NGF on the treatment of the control group. NIHSS, BI score, adverse reactions records were compared in two groups before and after treatment. The clinical effective rate were evaluated. Then BNP and NF-KB Level of patients in two groups before and after treatment were detected by using ELISA.ResultsThere were no significant differences in two groups before treatment with respect to NIHSS and BI score (P > 0.05). After treatment, NIHSS score in the observation group significantly lower than the control group. BI score in the observation group significantly higher than the control group, differences had obvious significance (P < 0.05). The total effective rate in the observation group was 93.75%. The control group was 70.83%. Clinical effective rate of patients in the observation group significantly better than the control group (P < 0.05). There were no significant differences of patients in two groups before treatment with respect to BNP and NF-kB Level (P > 0.05). BNP and NF-kB Level decreased with different levels in two groups after treatment, and the observation group lower than the control group at the same time (P < 0.05).ConclusionNGF is benefit for relieving neurological function injury of patients with acute cerebral hemorrhage in acute period, improving living ability of patients. Patients have good tolerance and no adverse reactions. NGF can lower BNP and NF-kB Level. It has a certain function of inhibiting inflammatory injury caused by cerebral hemorrhage, thus protecting neuron. It is worthy of clinical promotion.     

20-HETE contributes to the acute fall in cerebral blood flow after subarachnoid hemorrhage in the rat

This study examined the effects of blocking the formation of 20-hydroxyeicosatetraenoic acid (20-HETE) on the acute fall in cerebral blood flow after subarachnoid hemorrhage (SAH) in the rat. In vehicle-treated rats, regional cerebral blood flow (rCBF) measured with laser-Doppler flowmetry fell by 30% 10 min after the injection of 0.3 ml of arterial blood into the cisterna magna, and it remained at this level for 2 h. Pretreatment with inhibitors of the formation of 20-HETE, 17-octadecynoic acid (17-ODYA; 1.5 nmol intrathecally) and N-hydroxy-N'-(4-butyl-2-methylphenyl)formamidine (HET0016; 10 mg/kg iv), reduced the initial fall in rCBF by 40%, and rCBF fully recovered 1 h after induction of SAH. The concentration of 20-HETE in the cerebrospinal fluid rose from 12 +/- 2 to 199 +/- 17 ng/ml after SAH in vehicle-treated rats. 20-HETE levels averaged only 15 +/- 11 and 39 +/- 13 ng/ml in rats pretreated with 17-ODYA or HET0016, respectively. HET0016 selectively inhibited the formation of 20-HETE in rat renal microsomes with an IC(50) of <15 nM and human recombinant CYP4A11, CYP4F2, and CYP4F3 enzymes with an IC(50) of 42, 125, and 100 nM, respectively. These results indicate that 20-HETE contributes to the acute fall in rCBF after SAH in rats.