• 四川大學(xué)華西醫(yī)院麻醉科（610041 成都）;

目的 　系統(tǒng)評(píng)價(jià)納洛酮在成人心肺腦復(fù)蘇中的作用。
方法 　計(jì)算機(jī)檢索MEDLINE（1966～2006.6）、EMbase（1984～2006.6）、Cochrane圖書館（2006年第2期）和中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(1978～2006.6) 、中國(guó)期刊全文數(shù)據(jù)庫（1994～2006.6），納入納洛酮治療心肺腦復(fù)蘇的隨機(jī)對(duì)照試驗(yàn)（RCT）。由兩名研究者獨(dú)立進(jìn)行質(zhì)量評(píng)估和交叉核對(duì)，并采用RevMan4.2.7軟件進(jìn)行統(tǒng)計(jì)分析。
結(jié)果 　共納入10個(gè)RCT，研究對(duì)象均為年齡在18～75歲的急診搶救﹑留觀和住院的心搏驟停，需要進(jìn)行心肺復(fù)蘇的患者。納入研究的質(zhì)量均不高。結(jié)果表明納洛酮聯(lián)合常規(guī)心肺復(fù)蘇的療效優(yōu)于常規(guī)心肺復(fù)蘇。
結(jié)論 　納洛酮聯(lián)合常規(guī)心肺復(fù)蘇的成功率和神經(jīng)功能恢復(fù)優(yōu)于常規(guī)心肺復(fù)蘇。但由于納入研究的質(zhì)量較差，能夠合并的樣本例數(shù)較少，還需要進(jìn)行高質(zhì)量、大樣本隨機(jī)對(duì)照試驗(yàn)，才能為臨床工作提供充足的證據(jù)。

引用本文： 鄧 佳,李 茜,劉 斌. 納洛酮在成人心肺腦復(fù)蘇中的作用評(píng)價(jià). 中國(guó)循證醫(yī)學(xué)雜志, 2006, 06(11): 820-825. doi: 復(fù)制

1. 莊心良, 曾因明, 陳伯鑾. 主編. 現(xiàn)代麻醉學(xué). 第3版. 北京: 人民衛(wèi)生出社; 2004. 2306~2311.
2. 陳克田, 李明亭. 內(nèi)啡肽與納洛酮. 見: 孟慶林. 主編. 納洛酮的基礎(chǔ)研究與臨床應(yīng)用. 北京: 經(jīng)濟(jì)日?qǐng)?bào)出版社; 1996. 209.
3. 靳偉民, 韓樹堂. 鹽酸納洛酮治療顱腦損傷合并呼吸驟停 (附49例報(bào)告). 急診醫(yī)學(xué), 1997; 6(): 339.
4. 邵孝. 心肺腦復(fù)蘇. 見: 邵孝, 蔣朱明. 主編. 急診醫(yī)學(xué). 上海: 上?？茖W(xué)技術(shù)出版社; 1992. 55~69.
5. 孟慶林, 胡長(zhǎng)欣, 候延奎. 鹽酸納洛酮拮抗乙醇中毒作用機(jī)理的探討. 中國(guó)急救醫(yī)學(xué), 1996; 16(): 2.
6. 楊天德, 劉橋義, 陳意生, 等. 納洛酮對(duì)缺血再灌注心肌超微結(jié)構(gòu)的影響. 見: 孟慶林. 主編. 納洛酮的基礎(chǔ)研究與臨床應(yīng)用. 北京: 經(jīng)濟(jì)日?qǐng)?bào)出版社; 1996. 6~8.
7. 陳天鐸, 董晨明, 李培杰, 等. 納洛酮對(duì)心肺腦復(fù)蘇作用的評(píng)價(jià). 急診醫(yī)學(xué), 2000; (1): 5~7.
8. 李婷, 吳巖. 納絡(luò)酮用于心肺腦復(fù)蘇24例療效觀察. 吉林大學(xué)學(xué)報(bào)?醫(yī)學(xué)版, 2004; 30(5): 768.
9. 姚品安, 宋秀琴. 納洛酮在心肺腦復(fù)蘇中的療效觀察. 中國(guó)實(shí)用醫(yī)學(xué)研究雜志, 2004; 3(6): 507~508.
10. 車海明. 納洛酮在急性中毒心肺復(fù)蘇中的應(yīng)用. 中華臨床醫(yī)藥雜志, 2004; 5(2): 94.
11. 羅寶權(quán), 黃崇軍, 吳宗波, 等．納洛酮聯(lián)合腎上腺素進(jìn)行心肺復(fù)蘇. 臨床薈萃, 2003; 18(9): 523~524.
12. 郭美華, 任景艷, 趙莉. 納洛酮聯(lián)合腎上腺素進(jìn)行心肺復(fù)蘇的療效觀察. 實(shí)用醫(yī)技雜志, 2005; 12(2B): 459.
13. 劉秀娟, 余勝利. 納洛酮對(duì)心肺腦復(fù)蘇的臨床療效觀察. 貴州醫(yī)藥, 2002; 26(1): 40~41.
14. 林翔, 鄭偉, 朱宏剛. 鹽酸納洛酮在心肺腦復(fù)蘇急診搶救中的應(yīng)用. 中國(guó)廠礦醫(yī)學(xué), 2006; 19(1): 18~19.
15. 趙林明, 張兆順, 劉玉橋. 納洛酮治療呼吸心搏驟停患者臨床觀察. 現(xiàn)代中西醫(yī)結(jié)合雜志, 2006; 15(5): 584~585.
16. 王云峰, 王瑞斌. 納絡(luò)酮在腦復(fù)蘇中的療效觀察. 基層醫(yī)學(xué)論壇, 2004; 8(1): 43.
17. 郭美華, 任景艷, 趙莉. 納洛酮聯(lián)合腎上腺素心肺復(fù)蘇33例療效觀察. 中華全科醫(yī)師雜志, 2005; 4(9): 553.
18. 憔天鐸, 董晨明, 李培杰, 等. 心肺腦復(fù)蘇期間應(yīng)用納洛酮臨床價(jià)值的探討. 甘肅科技, 1999; (4).
19. 董晨明, 陳天鐸, 李培杰. 納洛酮在呼吸復(fù)蘇中的臨床應(yīng)用. 中國(guó)醫(yī)刊, 2000; 35(11): 49.
20. 董晨明, 李俠, 張京梅. 在心肺腦復(fù)蘇中納洛酮的臨床應(yīng)用體會(huì). 傷殘醫(yī)學(xué)雜志, 2000; 8(3): 38~40.
21. 陳天鐸, 董晨明, 李培杰. 納絡(luò)酮用于心肺腦復(fù)蘇21例療效觀察. 中國(guó)危重病急救醫(yī)學(xué), 2001; 13(3): 182.
22. 高超, 劉建中. 心肺復(fù)蘇中聯(lián)合應(yīng)用腎上腺素與納洛酮的研究. 寧夏醫(yī)學(xué)雜志, 2004; 26(11): 680~682.
23. 王偉強(qiáng), 沈建妹, 陳淑葉. 大劑量納洛酮心肺復(fù)蘇療效分析. 中國(guó)綜合臨床, 2003; 19(11): 989~990.
24. 崔小鋒. 常規(guī)心肺復(fù)蘇加用納洛酮救治心臟驟停體會(huì). 右江民族醫(yī)學(xué)院學(xué)報(bào), 2000; (3): 403~404.
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27. Zhuang XL, Zeng YM, Chen BL. Editor-in-chief. Modern Anesthesiology. 3rd ed. Beijing: People’s Medical Publishing House; 2004. 2306–2311.
28. Chen KT, Li MT. Endogenous opioid and naloxone. In: Meng QL. Editor-in-chief. Basic Research and Clinical Application of Naloxone. Beijing: Economic Daily Press; 1996. 209.
29. Le WM, Han ST. Effect of naloxone on craniocerebral injury and apnoea. Journal of Emergency Medicine, 1997; 6(): 339.
30. Shao X. Cardiopulmonary-cerebral Resuscitation. In: Shao X. Jiang ZM. editor-in-chief. Shanghai: Shanghai Science and Technique Press; 1992. 55–69.
31. Lou HC, Tweed WA, Davis JM. Preferential blood flow increase tothe brain stem in moderate neonatal hypoxia: reyersal by naloxone. EurJ Pediatr, 1985; 144(): 225.
32. Meng QL, Hu CX, Hou YK. Mechanism of antagonism of naloxone to ethanol. Chinese Journal of Critical Care Medicine, 1996; 16(): 2.
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  1. 1. 莊心良, 曾因明, 陳伯鑾. 主編. 現(xiàn)代麻醉學(xué). 第3版. 北京: 人民衛(wèi)生出社; 2004. 2306~2311.
  2. 2. 陳克田, 李明亭. 內(nèi)啡肽與納洛酮. 見: 孟慶林. 主編. 納洛酮的基礎(chǔ)研究與臨床應(yīng)用. 北京: 經(jīng)濟(jì)日?qǐng)?bào)出版社; 1996. 209.
  3. 3. 靳偉民, 韓樹堂. 鹽酸納洛酮治療顱腦損傷合并呼吸驟停 (附49例報(bào)告). 急診醫(yī)學(xué), 1997; 6(): 339.
  4. 4. 邵孝. 心肺腦復(fù)蘇. 見: 邵孝, 蔣朱明. 主編. 急診醫(yī)學(xué). 上海: 上?？茖W(xué)技術(shù)出版社; 1992. 55~69.
  5. 5. 孟慶林, 胡長(zhǎng)欣, 候延奎. 鹽酸納洛酮拮抗乙醇中毒作用機(jī)理的探討. 中國(guó)急救醫(yī)學(xué), 1996; 16(): 2.
  6. 6. 楊天德, 劉橋義, 陳意生, 等. 納洛酮對(duì)缺血再灌注心肌超微結(jié)構(gòu)的影響. 見: 孟慶林. 主編. 納洛酮的基礎(chǔ)研究與臨床應(yīng)用. 北京: 經(jīng)濟(jì)日?qǐng)?bào)出版社; 1996. 6~8.
  7. 7. 陳天鐸, 董晨明, 李培杰, 等. 納洛酮對(duì)心肺腦復(fù)蘇作用的評(píng)價(jià). 急診醫(yī)學(xué), 2000; (1): 5~7.
  8. 8. 李婷, 吳巖. 納絡(luò)酮用于心肺腦復(fù)蘇24例療效觀察. 吉林大學(xué)學(xué)報(bào)?醫(yī)學(xué)版, 2004; 30(5): 768.
  9. 9. 姚品安, 宋秀琴. 納洛酮在心肺腦復(fù)蘇中的療效觀察. 中國(guó)實(shí)用醫(yī)學(xué)研究雜志, 2004; 3(6): 507~508.
  10. 10. 車海明. 納洛酮在急性中毒心肺復(fù)蘇中的應(yīng)用. 中華臨床醫(yī)藥雜志, 2004; 5(2): 94.
  11. 11. 羅寶權(quán), 黃崇軍, 吳宗波, 等．納洛酮聯(lián)合腎上腺素進(jìn)行心肺復(fù)蘇. 臨床薈萃, 2003; 18(9): 523~524.
  12. 12. 郭美華, 任景艷, 趙莉. 納洛酮聯(lián)合腎上腺素進(jìn)行心肺復(fù)蘇的療效觀察. 實(shí)用醫(yī)技雜志, 2005; 12(2B): 459.
  13. 13. 劉秀娟, 余勝利. 納洛酮對(duì)心肺腦復(fù)蘇的臨床療效觀察. 貴州醫(yī)藥, 2002; 26(1): 40~41.
  14. 14. 林翔, 鄭偉, 朱宏剛. 鹽酸納洛酮在心肺腦復(fù)蘇急診搶救中的應(yīng)用. 中國(guó)廠礦醫(yī)學(xué), 2006; 19(1): 18~19.
  15. 15. 趙林明, 張兆順, 劉玉橋. 納洛酮治療呼吸心搏驟?；颊吲R床觀察. 現(xiàn)代中西醫(yī)結(jié)合雜志, 2006; 15(5): 584~585.
  16. 16. 王云峰, 王瑞斌. 納絡(luò)酮在腦復(fù)蘇中的療效觀察. 基層醫(yī)學(xué)論壇, 2004; 8(1): 43.
  17. 17. 郭美華, 任景艷, 趙莉. 納洛酮聯(lián)合腎上腺素心肺復(fù)蘇33例療效觀察. 中華全科醫(yī)師雜志, 2005; 4(9): 553.
  18. 18. 憔天鐸, 董晨明, 李培杰, 等. 心肺腦復(fù)蘇期間應(yīng)用納洛酮臨床價(jià)值的探討. 甘肅科技, 1999; (4).
  19. 19. 董晨明, 陳天鐸, 李培杰. 納洛酮在呼吸復(fù)蘇中的臨床應(yīng)用. 中國(guó)醫(yī)刊, 2000; 35(11): 49.
  20. 20. 董晨明, 李俠, 張京梅. 在心肺腦復(fù)蘇中納洛酮的臨床應(yīng)用體會(huì). 傷殘醫(yī)學(xué)雜志, 2000; 8(3): 38~40.
  21. 21. 陳天鐸, 董晨明, 李培杰. 納絡(luò)酮用于心肺腦復(fù)蘇21例療效觀察. 中國(guó)危重病急救醫(yī)學(xué), 2001; 13(3): 182.
  22. 22. 高超, 劉建中. 心肺復(fù)蘇中聯(lián)合應(yīng)用腎上腺素與納洛酮的研究. 寧夏醫(yī)學(xué)雜志, 2004; 26(11): 680~682.
  23. 23. 王偉強(qiáng), 沈建妹, 陳淑葉. 大劑量納洛酮心肺復(fù)蘇療效分析. 中國(guó)綜合臨床, 2003; 19(11): 989~990.
  24. 24. 崔小鋒. 常規(guī)心肺復(fù)蘇加用納洛酮救治心臟驟停體會(huì). 右江民族醫(yī)學(xué)院學(xué)報(bào), 2000; (3): 403~404.
  25. 25. 馬玉英, 杜廣勝, 楊晚青, 等. 鹽酸納洛酮在腦復(fù)蘇中的療效觀察. 農(nóng)墾醫(yī)學(xué), 2000; 22(2): 91.
  26. 26. 曹秋菊, 孫瑞林. 納洛酮用于心腦肺復(fù)蘇術(shù)31例臨床分析. 鎮(zhèn)江醫(yī)學(xué)院學(xué)報(bào), 1999; 9(2): 229.
  27. 27. Zhuang XL, Zeng YM, Chen BL. Editor-in-chief. Modern Anesthesiology. 3rd ed. Beijing: People’s Medical Publishing House; 2004. 2306–2311.
  28. 28. Chen KT, Li MT. Endogenous opioid and naloxone. In: Meng QL. Editor-in-chief. Basic Research and Clinical Application of Naloxone. Beijing: Economic Daily Press; 1996. 209.
  29. 29. Le WM, Han ST. Effect of naloxone on craniocerebral injury and apnoea. Journal of Emergency Medicine, 1997; 6(): 339.
  30. 30. Shao X. Cardiopulmonary-cerebral Resuscitation. In: Shao X. Jiang ZM. editor-in-chief. Shanghai: Shanghai Science and Technique Press; 1992. 55–69.
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