醒脑静注射液联合低分子肝素治疗急性一氧化碳中毒迟发性脑病的临床研究  

Clinical Study of Xingnaojing Injection Combined with Low Molecular Weight Heparin in the Treatment of Delayed Encephalopathy Caused by Acute Carbon Monoxide Poisoning

作　　者：庞国忠[1] 孙爱芹 刘文帅[1] 宋新峰 PANG Guo-zhong;SUN Ai-qin;LIU Wen-shuai;SONG Xin-feng(ICU, Dezhou People's Hospital, Dezhou, Shandong Province, 253000 China;Dezhou College of Medicine and Nursing, Dezhou, Shandong Province, 253000 China)

机构地区：[1]德州市人民医院ICU,山东德州253000 [2]德州学院医药与护理学院,山东德州253000

出　　处：《世界复合医学》2019年第7期177-179,198,共4页World Journal of Complex Medicine

摘　　要：目的探讨醒脑静注射液联合低分子肝素对急性一氧化碳中毒迟发性脑病(DEACMP)的治疗作用。方法以2013年9月—2018年9月于该院住院的62例DEACMP患者为研究对象,随机分为治疗组和对照组,均给予高压氧、脱水、营养脑神经等常规治疗,治疗组加用醒脑静及低分子肝素,疗程共计14d,治疗过程中复查相关指标,3个月时随访,比较临床转归及相关指标变化。结果治疗组14d时有效率为83.87%,优于对照组(70.97%),但差异无统计学意义(χ^2=2.783,P>0.05),3个月时有效率达93.55%,明显优于对照组(70.97%),差异有统计学意义(χ^2=4.128,P<0.05),提示治疗组临床转归优于对照组。治疗组14d及3个月时下肢肌间静脉血栓形成发生率(3.23%vs6.45%)明显低于对照组(12.90%vs16.13%),差异有统计学意义(χ^2=5.486、5.292,P<0.05),D-二聚体异常率在14d时下降(3.23%),明显低于对照组(29.03%),差异有统计学意义(χ^2=6.364,P<0.05),且此统计学差异持续至3个月。治疗组14d时血栓弹力图异常率(6.45%)明显低于对照组(25.81%),差异有统计学意义(χ^2=5.867,P<0.05),但是此差异在3个月时消失。结论在常规治疗措施下,联合应用醒脑静及低分子肝素可促进DEACMP患者神经功能恢复,有效降低血栓栓塞事件。Objective To investigate the therapeutic effect of Xingnaojing injection combined with low molecular weight heparin on acute carbon monoxide poisoning delayed encephalopathy (DEACMP). Methods A total of 62 patients with DEACMP admitted to our hospital from September 2013 to September 2018 were randomly divided into treatment group and control group. All patients were treated with hyperbaric oxygen, dehydration, nutritional cranial nerve and other treatments. The patients were treated with Xingnaojing and low molecular weight heparin for a total of 14 d. The relevant indicators were reviewed during the treatment, and the patients were followed up at 3 months to compare the clinical outcomes and related indicators. Results The effective rate was 83.87% in the treatment group at 14 d, which was better than that in the control group (70.97%), but the difference was not statistically significant (χ^2=2.783, P>0.05). The effective rate was 93.55% at 3 months, which was significantly better than the control group (70.97%), the difference was statistically significant (χ^2=4.128, P<0.05), suggesting that the clinical outcome of the treatment group was superior to the control group. The incidence of lower extremity intermuscular venous thrombosis (3.23% vs 6.45%) was significantly lower in the treatment group than in the control group (12.90% vs 16.13%) at 14 d and 3 months, and the difference was statistically significant (χ^2=5.486,5.292, P<0.05), the abnormal rate of D-dimer decreased at 14 d(3.23%), significantly lower than the control group (29.03%), the difference was statistically significant (χ^2=6.364, P<0.05), and the statistical difference lasts up to 3 months. The abnormal rate of thromboelastography (6.45%) was significantly lower in the treatment group than in the control group at 14 d (25.81%), and the difference was statistically significant (χ^2=5.867, P<0.05), but the difference disappeared at 3 months. Conclusion Under conventional treatment, combined use of Xingnaojing and low molecular weight hep

关 键 词：一氧化碳中毒迟发性脑病 醒脑静注射液 低分子肝素 

分 类 号：R749.63[医药卫生—神经病学与精神病学]