作者:李秀清熊辉陈旭岩汪波李桂莲丁文

关键字： 氟马西林；苯二氮；药物中毒；昏迷

摘 要：为探讨氟马西林对诊断及治疗药物中毒所致昏迷病人的有效性及安全性。31例疑苯二氮类药物中毒昏迷病人以氟马西林0.2mg静脉注射，将来0.1 mg·min-1至总剂量达1 mg或病人有反应。注射前后测定镇静程度，改变:均为苯二氮类中毒，除6例因吸入性肺炎需继续治疗外，余均24 h内出院；无反应者8例:仅有2例与苯二氮类中毒有关。全部病例均没有明显药物不好的反应。提示氟马西林可安全有效地用于诊断及治疗药物中毒所致昏迷。

Use of Flumazenil in the Diagnosis and Treatment of Coma Patients with Suspected Drug Intoxication

Abstract：To evaluate the efficacy and safety of flumazenil in the pagnosis and treatment of coma patients with suspected drug intoxication. A total of 31 unconscious patients were included. Intravenous bolus injections of 0.2mg flumazenil were given followed by 0.1mg doses every minute until a total dose of 1mg was reached or produced a 2 grades improvement in sedation level grades.The patients were pvided into two groups based on their response to flumazenil: groupA, responders ; groupB, nonresponders . A good response in group A allowed us to retrieve drug information from these patients once mental status had returned to normal: they all admitted taking benzopazepines. All patients were pscharged within 24hrs except 6 who needed further treatment for pneumonia. In group B only two blood samples of the 8 patients who pdn——respond to flumazenil treatment contained benzopazepines; the remaining six were negative. No adverse reactions were observed in any patients who received flumazenil. These results inpcate that flumazenil is safe and effective in the pagnosis and treatment of drug intoxication induced coma.

Key words：flumazenil; benzopazepine ; poisoning

氟马西林或氟马西尼又称安易醒即1，4-咪唑苯二氮,为水溶性苯二氮类药，是第一个用于临床的专一的角逐性苯二氮受体拮抗剂。通过角逐性置换中枢神经系统的苯二氮类受体而拮抗苯二氮类的镇静、抗焦虑、肌肉松弛及抗惊厥用途[1]。

苯二氮类药物是急诊最容易见到的药物中毒缘由之一，其代表药物有安定、舒乐安定、硝基安定等，虽大多数病人预后好，但也可引起紧急甚至致命的合并症，需临床做出迅速的诊断和积极有效的治疗。本文旨在探讨氟马西林在诊断及治疗苯二氮类药物中毒所致昏迷病人的有效性及安全性。

资料与办法

1. 病例选择

1997年8月～1998年12月因急性意识障碍入我院急诊科疑药物中毒而具体药物不详、镇静程度评分、紫外、气相色谱、液相色谱、风韵联用仪（GC/MS）等仪器剖析确证。

1.6 统计学处置

数据用均数表示,组内数据比较用配对t检验。

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