【摘要】 目的 观察血液灌流联合盐酸纳洛酮治疗急性重症镇静药物中毒患者的临床效果。方法 选取2019年7月—2023年7月长治市人民医院急诊科治疗的急性重症镇静药物中毒患者120例为研究对象。按照随机数字表法分为对照组和研究组，各60例。对照组给予盐酸纳洛酮静脉滴注，研究组在对照组基础上给予血液灌流治疗。比较2组临床疗效、意识清醒时间、中毒症状消失时间、住院时间、血气指标水平[pH、动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）]、血清炎性因子水平[白介素-4（IL-4）、IL-6、肿瘤坏死因子-α（TNF-α）]及并发症发生率。结果 研究组临床总有效率为93.33%,高于对照组的76.67%（χ²/P=6.536/0.011）;治疗后研究组患者意识清醒时间、中毒症状消失时间、住院时间短于对照组（t/P=6.675/<0.001、6.004/<0.001、7.174/<0.001）;与治疗前比较，治疗后患者PaCO₂、IL-4、IL-6、TNF-α水平均下降，pH、PaO₂上升（P<0.05）,且研究组降低/升高幅度大于对照组（t/P=6.745/<0.001、5.729/<0.001、6.922/<0.001、6.169/<0.001、2.419/0.017、4.291/<0.001）;治疗后研究组并发症总发生率为3.33%,低于对照组的15.00%（χ²/P=4.904/0.027）。结论 血液灌流联合盐酸纳洛酮治疗急性重症镇静药物中毒患者，可有效改善血气状况，降低炎性反应，促进患者恢复。更多还原

【Abstract】 Objective To observe the clinical efficacy of blood perfusion combined with naloxone hydrochloride in the treatment of patients with acute severe sedative drug poisoning. Methods One hundred and twenty patients with acute severe sedative drug poisoning treated in the Emergency Department of Changzhi People’s Hospital from July 2019 to July 2023 were selected as the study subjects. Divide into a control group and a study group using a random number table method, with 60 cases in each group. The control group received intravenous infusion of naloxone hydrochloride, while the study group received hemoperfusion treatment on the basis of the control group. Compare the clinical efficacy, wakefulness time, disappearance time of toxic symptoms, length of hospital stay, blood gas index levels [pH, arterial oxygen pressure（PaO₂）, arterial carbon dioxide pressure（PaCO₂）], serum inflammatory factor levels [interleukin-4（IL-4）, IL-6, tumor necrosis factor-α（TNF-α）] And the incidence of complications. Results The total clinical effective rate of the research group was 93.33%, higher than 76.67% in the control group（χ²/P=6.536/0.011）. After treatment, the patients in the study group had shorter periods of consciousness, disappearance of toxic symptoms, and hospital stay compared to the control group（t/P=6.675/<0.001, 6.004/<0.001, 7.174/<0.001）. Compared with before treatment, the PaCO₂, IL-4, IL-6, TNF-α of patients after treatment were decreased, and pH, PaO₂ increased（P<0.05）, and the decrease/increase amplitude in the study group was greater than that in the control group（t/P=6.745/<0.001, 5.729/<0.001, 6.922/<0.001, 6.169/<0.001, 2.419/0.017, 4.291/<0.001）. The total incidence of complications in the study group after treatment was 3.33%, lower than the 15.00% in the control group（χ²/P=4.904/0.027）. Conclusion Hemoperfusion combined with naloxone hydrochloride can effectively improve blood gas status, reduce inflammatory reactions, and promote patient recovery in patients with acute severe sedative drug poisoning.更多还原