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纳洛酮对失血性休克的临床疗效

[Clinical effects of naloxone on hemorrhagic shock].

作者信息

Lu H, Xu G, Sheng Z

机构信息

Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang.

出版信息

Zhonghua Wai Ke Za Zhi. 1995 Jun;33(6):355-8.

PMID:8582220
Abstract

In order to study the clinical effects of naloxone on hemorrhagic shock, 21 patients with moderate hemorrhagic shock were randomly divided into two groups. The naloxone group (NLX group) was infused normal saline (200ml) and naloxone (0.02mg/kg) via central vein while the control group was infused normal saline (200ml) only. Mean arterial pressure (MAP), central vein pressure (CVP), cardiac output (CO), cardiac index (CI), peripheral vascular resistance (PVR), levels of lactic acid in both artery and vein, and levels of catecholamine in artery were measured before and after the administration of naloxone or normal saline. The results showed that naloxone significantly increased blood level of catecholamine and MAP (P < 0.01), the effects sustained for more than 15 minutes with an increased PVR (P < 0.05). After infustion of normal saline, blood level of lactic acid in artery and vein decreased slightly (P > 0.05), yet comparatively lower in artery. On the contrary, after administration of naloxone, the blood level of lactic acid markedly decreased in both artery and vein (P < 0.01), but higher in artery. It is suggested that naloxone improve tissue oxygen supply temporarily with enhancement of tissue lactic acid metabolism.

摘要

为研究纳洛酮对失血性休克的临床疗效,将21例中度失血性休克患者随机分为两组。纳洛酮组(NLX组)经中心静脉输注生理盐水(200ml)和纳洛酮(0.02mg/kg),而对照组仅输注生理盐水(200ml)。在输注纳洛酮或生理盐水前后,测量平均动脉压(MAP)、中心静脉压(CVP)、心输出量(CO)、心脏指数(CI)、外周血管阻力(PVR)、动静脉血乳酸水平以及动脉血儿茶酚胺水平。结果显示,纳洛酮可显著提高血儿茶酚胺水平和MAP(P<0.01),其作用持续超过15分钟,同时PVR升高(P<0.05)。输注生理盐水后,动静脉血乳酸水平略有下降(P>0.05),但动脉血乳酸水平相对较低。相反,给予纳洛酮后,动静脉血乳酸水平均显著下降(P<0.01),但动脉血乳酸水平较高。提示纳洛酮可通过增强组织乳酸代谢而暂时改善组织氧供。

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