高压氧加抗血小板聚集剂治疗一氧化碳中毒迟发脑病临床探究.docVIP

高压氧加抗血小板聚集剂治疗一氧化碳中毒迟发脑病临床探究【摘要】 目的 观察应用高压氧(HBO)加抗血小板聚集剂综合治疗一氧化碳中毒(COP)迟发脑病的临床疗效。方法 COP迟发脑病患者101例,随机分为抗聚集组66例,行HBO加抗血小板聚集剂治疗;对照组35例,行HBO加常规内科治疗。结果 抗聚集组疗效显著优于对照组,两组疗效比较差异具有统计学意义(P0．01)。结论 HBO加抗血小板聚集剂治疗COP迟发脑病疗效优于HBO加常规内科治疗。HBO加抗血小板聚集剂治疗COP迟发脑病能提高其救治成功率，减少致残率和死亡率,是比较有效的治疗方案。 【关键词】高压氧；抗血小板聚集剂；一氧化碳中毒；迟发脑病 The clinical study combined with antiagglutinin of treating late encephalopathy in carbon monxige poisoning patients with hyperberic oxygen(HBO) SUN Le-ting.The Peoples Hospital of Mengyin County,Shandong Prouince,276200,China 【Abstract】 Objective To study the clinical effect of treating late encephalopathy in carbon monxide poisoning patients with HBO combined with variant medical ways.Methods 101 patients were choosed and avevaged into the anticoagulant group(66 cases)and the control group(35 cases).The anticoagulant group were treated with HBO combined with antiagglutinin.The control group were treated with drugs of nutriment cell of brain.Results The cure result of the anticoagulant group was better than the control group.The contrast of the two groups has the mathematical sense(P0．01).Conclusion HBO combined with antiagglutinin was a good way in treating the late encephalopathy in carbon monxide poisoning patients.It can increase the rate of cure and lessen the rate of mutilation and death. 【Key words】 Hyperberic oxygen；Antiagglutinin;Carbon monxide poisoning； Late encephalopathy 中重度COP患者在治疗清醒后经过一段假愈期出现一系列神经精神症状,严重患者表现痴呆、震颤、表情淡漠或有乱语。其发病原因尚未明了。有实验证明，COP后血浆NO水平降低,血小板活性增高[1]。提示COP后血小板活性增高可引起脑小动脉血栓形成,造成脑组织广泛缺血缺氧,是COP迟发脑病的重要因素之一。我们自1999年以来应用HBO加抗聚集剂治疗COP迟发脑病取得了显著疗效,现报告如下。 1 材料与方法 1．1 临床资料 两组患者均系生活中燃煤取暖发生意外,均有急性COP后意识障碍恢复或昏迷后经过10~30 d的“假愈期”再次发生神经精神障碍的病史。两组患者全部来自我院神经内科住院患者,以1994年1月至2004年12月在本院治疗的COP迟发脑病患者101例为研究对象,随机分为抗聚集治疗组66例,行HBO加抗血小板聚集剂治疗;对照组35例,行HBO加常规内科治疗。两组患者性别、年龄、临床表现分别见表1、2。 1．2 治疗方法 ①HBO治疗:两组均采用多人空气加压舱,加压至0．15 MPa(表压),用面罩吸纯氧60 min，中间休息10 min,1次/d,共30次;②药物治疗:抗聚集组静脉滴注低分子右旋糖酐500 ml/d,复方丹参20 ml/d,口服低克力得0．25/d，共30 d;对照组静脉给药有脑活素(脑复康)、胞二磷胆