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目的分析小儿复方苯乙哌啶中毒的临床表现,纳洛酮在其中毒时的救治方法以及如何预防。方法收集、整理、分析2007年1月-2010年7月收治的34例复方苯乙哌啶中毒患儿的临床资料。中毒患儿给予纳洛酮首次剂量0.03~0.05 mg/kg静脉推注治疗,根据病情严重程度可于2h后重复使用;重度患儿于首次注射后改静脉滴注维持2~3d,剂量为10~20μg(kg.h)。结果轻症复方苯乙哌啶中毒可引起发热、精神差、嗜睡、呕吐、腹胀、便秘等,重者可引起昏迷、抽搐、呼吸抑制、循环衰竭甚至脑出血、死亡。应用特效解毒药纳洛酮治疗,1例超大剂量误服患儿给予气管插管、呼吸机辅助通气,经治疗后好转,其余33例均治愈,治愈率97%。结论复方苯乙哌啶治疗小儿腹泻安全范围小,不良反应大,临床对小儿应禁用或慎用。早期诊断,早期使用纳洛酮,是复方苯乙哌啶中毒抢救成功的关键。
Objective To analyze the clinical manifestations of compound dipyridamole in children and the treatment and prevention of naloxone when it is poisoned. Methods The clinical data of 34 patients with compound diphenoxylate poisoning were collected, sorted out and analyzed from January 2007 to July 2010. Children with poisoning given naloxone for the first dose of 0.03 ~ 0.05 mg / kg intravenous injection, according to the severity of the disease can be re-used after 2h; severe infants after the first injection to change intravenous infusion to maintain 2 ~ 3d, a dose of 10 ~ 20μg (kg.h). Results mild diphenoxylate poisoning can cause fever, poor spirits, drowsiness, vomiting, bloating, constipation, severe cases can cause coma, convulsions, respiratory depression, circulatory failure and even cerebral hemorrhage and death. Application of special effects detoxification drug naloxone treatment, 1 case of large doses of mistreatment children given tracheal intubation, ventilator-assisted ventilation, improved after treatment, and the remaining 33 cases were cured, the cure rate was 97%. Conclusion The compound diphenoxylate treatment of children with small safety range of diarrhea, adverse reactions, clinical should be disabled or used with caution in children. Early diagnosis, early use of naloxone, is the key to the success of compound diphenoxylate poisoning.