丹参川芎嗪注射液联合神经节苷脂治疗一氧化碳中毒后患者脑氧利用率的变化及意义  

Changes and significance of cerebral oxygen utilization coefficients in patients with acute carbon monoxide poisoning after treatment with Danshen Chuanxiongqin injection combined with ganglioside

作　　者：齐洪娜[1] 王磊[1] 安立娟[1] 孔繁托 肖青勉[1] 王维展[1] 王璞[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院急救医学部,河北衡水053000

出　　处：《中国中西医结合急救杂志》2017年第2期143-146,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：河北省衡水市科技计划项目（13007Z）

摘　　要：目的观察急性一氧化碳中毒（ACOP）患者应用丹参川芎嗪注射液联合神经节苷脂治疗后脑氧利用率（O2UCc）的变化及意义。方法采用前瞻性研究方法，选择2011年1月至2016年1月入住河北医科大学附属哈励逊国际和平医院急救医学部的206例ACOP患者，按随机数字表法分为丹参川芎嗪组、神经节苷脂组和丹参川芎嗪注射液联合神经节苷脂治疗组（联合治疗组）。所有患者均于治疗前及治疗后6h、1d、3d经颈内动脉和颈内静脉采血，检测颈内动脉血氧饱和度（SaO2）和颈内静脉血氧饱和度（SjO2），根据公式推导O2UCc[O2UCc=s（a—i）O2／SaO2]。比较3组患者治疗前后O2UCc的变化；观察治疗14d后患者临床症状改善情况、ACOP迟发性脑病（DEACMP）的发生率及28d病死率。结果联合治疗组总有效率明显高于丹参川芎嗪组和神经节苷脂组[91．67％（66／72）比77．27％（51／66）、77．94％（53／68），均P〈0．05]。3组患者治疗前O2UCc水平比较差异无统计学意义；治疗后6h和1d联合治疗组O，UCc均明显低于丹参川芎嗪注射液组和神经节苷脂组[6h：（38．13±7．95）％比（42．96±7．58）％、（42．30±9，87）％，1d：（28．42±5．41）％比（33．27±7．53）％、（32．64±6．76）％，均P〈0．05]，而丹参川芎嗪组、神经节苷脂组患者治疗6h和1d后O2UCc比较差异无统计学意义；治疗3d后丹参川芎嗪组、神经节苷脂组、联合治疗组O2UCc水平数值已接近[分别为（23．87±6．06）％、（22．38±6．09）％、（23．68±4．34）％，均P〉0．05]。联合治疗组DEACMP发生率和28d病死率均低于丹参川芎嗪组和神经节苷脂组[发生率：2．78％（2／72）比12．12％（8／66）、14．71％（10／68），28d病死率：2．78％（2／72）比13．64％（9／66）、16.18％（11／68），均JP〈0．05]，而丹参川芎嗪组与神经节苷脂组DEACMP发生率和28d病�Objective To investigate the changes and significance of cerebral oxygen utilization coefficients （O2UCc） in patients with acute carbon monoxide poisoning （ACOP） after treatment with Danshen Chuanxiongqin injection combined with ganglioside. Methods A prospective study was conducted. Two hundreds and six patients with ACOP admitted to the Department of Emergency in Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2011 to January 2016 were enrolled, and they were divided into Danshen Chuanxiongqin group, ganglioside group and Danshen Chuanxiongqin injection combined with ganglioside group （combined treatment group） by random number table. The changes in oxygen saturation of internal carotid artery blood （SaO2） and oxygen saturation of internal jugular vein blood （SjO2） were detected by blood gas analysis for all the patients before and 6 hours, 1 day, 3 days after treatment, and then according to the rate of oxygen utilization formula [O2UCc= S（a-j）O2/ SaO2], O2UCe was calculated. Before and aflter treatment, the changes of O2UCc in three groups were compared; after treatment for 14 days, the improvement of clinical symptoms, the incidence of delayed encephalopathy after acute carbon monoxide poisoning （DEACMP） and the 28-day mortality were observed. Results The total therapeutic effective rate of combined treatment group was significantly higher than that in either Danshen Chuanxiongqin injection group or ganglioside group [91.67% （66/72） vs. 77.27% （51/66）, 77.94% （53/68）, both P 〈 0.05]. Before treatment, there were no differences in levels of O2UCe among three groups （P 〉 0.05）; after treatment for 6 hours and 1 day, the level of O2UCc in combined treatment group was obviously lower than either that of Danshen Chuanxiongqin injection group or of ganglioside group [6 hours： （38.13±7.95）% vs. （42.96±7.58）%, （42.30±9.87）%, 1 day： （28.42±5.41）% vs. （33.27±7.53）%, （32.64 ± 6.76）%, all P 〈 0.0

关 键 词：一氧化碳中毒 急性 丹参川芎嗪注射液 神经节苷脂 脑氧利用率 

分 类 号：R286[医药卫生—中药学]