醒腦靜聯合乙酰谷酰胺治療急性重度一氧化碳中毒4 5例臨床觀察

陸 巖，方建飛，王 芳，羅曉燕，李 偉

（河北省開灤總醫院，河北 唐山 063000）

醒腦靜聯合乙酰谷酰胺治療急性重度一氧化碳中毒4 5例臨床觀察

陸 巖，方建飛，王 芳，羅曉燕，李 偉

（河北省開灤總醫院，河北 唐山 063000）

目的探討醒腦靜聯合乙酰谷酰胺治療急性重度一氧化碳中毒的臨床療效。方法 選擇醫院2012年1月至2017年1月收治的急性重度一氧化碳中毒患者90例，按隨機數字表法分為對照組和觀察組，各45例。兩組患者均給予高壓氧艙、營養神經、甘露醇脫水降顱壓和改善循環等基礎治療，對照組患者在此基礎上給予乙酰谷酰胺靜脈滴注，觀察組在對照組治療基礎上給予醒腦靜靜脈滴注。結果 觀察組總有效率為93．33%，顯著高于對照組的75．56%（P＜0．05）；治療后，兩組患者格拉斯哥昏迷評分（GCS）和血清超氧化物歧化酶（SOD）水平均明顯升高，且觀察組升高更顯著（P＜0．05）；觀察組患者遲發性腦病發生率為4．44%，顯著低于對照組的22．22%（P＜0．05）。結論 醒腦靜聯合乙酰谷酰胺治療急性重度一氧化碳中毒療效顯著，能有效改善患者的臨床表現，促進患者意識恢復，升高血清SOD水平，減少遲發性腦病的發生，值得臨床推廣。

醒腦靜；乙酰谷酰胺；急性重度一氧化碳中毒；臨床療效

Abstract：Objective To investigate the clinical effect of Xingnaojing combined with acetylglutamide in the treatment of acute severe carbon monoxide poisoning．M ethods A total of 90 patients with acute severe carbon monoxide poisoning admitted to our hospital from January 2012 to January 2017 were selected and divided into the control group（n＝45）and the observation group（n＝45）according to random number table method．The two groups were treated with hyperbaric oxygen，nutrition nerve，mannitol dehydration to reduce intracranial pressure and improve circulation and other basic treatment，on this basis，the control group was treated with acetylglutamide，while the observation group was additionally treated with Xingnaojing on the basis of the control group．Resu lts The total effective rate of the observation group was 93．33%，which was significantly higher than 75．56% of the control group（P＜0．05）．After treatment，the GCS score and serum SOD level were significantly increased in the two groups，and the observation group was increased more significantly（P＜0．05）．The incidence rate of delayed encephalopathy of the observation group was 4．44%，which was significantly lower than 22．22% of the control group（P ＜0．05）．Conclusion Xingnaojing combined with acetylglutamide is effective in the treatment of patients with severe acute carbon monoxide poisoning，and it also can reduce the incidence of delayed encephalopathy，which is worthy of clinical promotion．

Key words：Xingnaojing；acetylglutamide；severe acute carbon monoxide poisoning；clinical effect

急性一氧化碳中毒是吸入較高濃度一氧化碳后引起的急性缺氧性腦病，部分患者會有遲發性神經精神癥狀或其他臟器的缺氧性改變，發病人數和死亡人數均居我國急性職業性化學物中毒前列，危害很大[1－2]。其嚴重程度不僅與空氣中一氧化碳濃……