本文關鍵詞： 譫妄 老年人 納洛酮 奧氮平　出處：《中國全科醫(yī)學》2015年17期 　論文類型：期刊論文

【摘要】：目的探討納洛酮聯(lián)合奧氮平治療老年譫妄的療效、起效時間及安全性。方法選取2010年1月—2013年10月在浙江蕭山醫(yī)院住院期間發(fā)生老年譫妄的患者66例,采用隨機數(shù)字表法將患者分為試驗組和對照組,各33例。兩組均根據(jù)譫妄病因給予針對性治療,試驗組在此基礎上給予奧氮平治療,起始劑量1.25~2.50 mg/d,之后劑量在1.25~10.00 mg/d調整,同時給予0.9%氯化鈉溶液100 ml+納洛酮0.8 mg,靜脈滴注,1次/d。對照組給予奧氮平口服或舌下含服治療,起始劑量1.25~2.50 mg/d,之后劑量在1.25~10.00 mg/d調整。分別在兩組患者治療前、治療第1~7天,以臨床總體印象量表(CGI-SI、CGI-GI)分別評價患者精神障礙嚴重程度及癥狀改善情況,并將觀察期內CGI-SI基線分減少≥1分時用藥劑量及時間分別作為起效劑量和起效時間。在觀察期內由會診醫(yī)生評定患者譫妄分級量表-98修訂版(DRS-R-98)評分。結果對照組因自動出院脫落3例,轉ICU插管上呼吸機治療脫落1例,共完成29例;試驗組因自動出院脫落1例,共完成32例。兩組治療前CGI-SI評分比較,差異無統(tǒng)計學意義(P0.05);試驗組治療后CGI-SI評分低于對照組(P0.05);兩組治療后CGI-SI評分均較治療前降低(P0.05)。治療后,對照組顯效率為69.0%(20/29),低于試驗組的96.9%(31/32)(χ2=6.60,P0.05)。試驗組起效劑量低于對照組,起效時間短于對照組(P0.05)。兩組治療前后DRS-R-98評分時間與組間存在交互作用(P0.05);組間比較:兩組治療第2~5天,試驗組DRS-R-98評分均低于對照組(P0.05);不同時間點比較:對照組治療第3~7天DRS-R-98評分均低于治療前,試驗組治療第2~7天DRS-R-98評分均低于治療前(P0.05)。兩組在觀察期內均無因嚴重的藥物不良反應而中斷治療者。結論納洛酮聯(lián)合奧氮平治療老年譫妄起效快、療效好,奧氮平的起效劑量低,使用劑量小,安全性高。
[Abstract]:Objective to investigate the efficacy, onset time and safety of naloxone combined with olanzapine in the treatment of senile delirium. Methods 66 cases of senile delirium in Zhejiang Xiaoshan Hospital from January 2010 to October 2013 were selected. Patients were divided into trial group and control group with 33 cases each. The two groups were given targeted treatment according to the etiology of delirium. The experimental group was treated with olanzapine at the initial dose of 1.25 ~ 2.50 mg / d, then the dose was adjusted at 1.25 ~ 10.00 mg/d. The control group was given olanzapine oral or sublingual oral administration, the initial dose was 1.25 ~ 2.50 mg / d, and the later dose was adjusted at 1.25 ~ 10.00 mg/d. The severity of mental disorders and the improvement of symptoms were evaluated by CGI-SIN CGI-GI. The dosage and time of medication were taken as the effective dose and time when the baseline score of CGI-SI decreased 鈮，

本文編號：1502611