[目的]比较海洛因依赖者清醒状态下快速脱毒与纳曲酮冲击疗法的优劣.[方法]海洛因依赖者清醒状态下用丁丙诺啡,纳洛酮注射液进行快速脱毒为A组(30例);选择年龄、性别、滥用史、滥用方式、末周日滥用量基本一致者,采用纳曲酮冲击疗法者为B组(30例)进行对照.按纳曲酮冲击疗法操作程序准备及用药.比较两组住院至冲击治疗时间,冲击治疗中反应及治疗后戒断症状,不良反应等.A组患者治疗前后进行血常规、肝功能、肾功能及心电图检查.[结果]A组患者平均住院4 d左右完成脱毒,较B组(平均6.4 d)明显提前完成脱毒(P<0.01).A组治疗时间,平均2 h,病人一直处于清醒状态,治疗期间各项生命体征正常、平稳.治疗后戒断症状轻,无不良反应.治疗时间明显短于B组(P<0.01),对肝功能、肾功能、心电图没有明显影响,冲击成功率100%.[结论]海洛因依赖者清醒状态下快速脱毒安全性更高、依从性更好、可操作性更强、戒断症状及不良反应更轻;是目前较好的快速脱毒方法,很有临床实用价值.%[Objective] To compare the advantages and disadvantage of fast detoxification therapy in conscious state vs naltrexone stosstherapy for heroin dependents. [Methods] Thirty heroin dependents(group A)accepted the fast detoxification therapy in conscious state, while other 30 cases(group B) matched to cases in group A with age, sex, drug abuse history as control accepted naltrexone stosstherapy. Withdrawal symptoms and side effects were evaluated and compared between the two groups. Cases in group A also received ECGs,liver function test, kidney test and blood routine test before and after detoxification therapy. [Results] The average time intervals from admission to acceptance of detoxification therapy in group A were 4 days in hospital which was shorter than those in group B(6.4 days)( P ＜0.01). The average time of detoxification treatment in group A was 2 hours. During treatment, cases in group A were conscious and their life signs were normal.After treatment, the withdrawal symptoms and side effects in cases from group A were milder than in cases from group B. Additionally, the fast detoxification therapy had no obvious influence on the ECGs, liver function test, kidney test and blood test, and all of the cases in group A were successfully detoxified. [Conclusion] The fast detoxification therapy in conscious state is safer, easier to comply and maneuver, and has less withdraw symptoms and side effects, so it is a good fast detoxification method and has practical value in clinical work.
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