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目的观察舒血宁注射液、低分子肝素钙联合高压氧治疗中重度急性一氧化碳(CO)中毒的临床疗效。方法选取河北省邢台市第三医院2005年12月—2015年1月收治的中重度急性CO中毒患者152例,随机分为对照组72例和治疗组80例。对照组患者采用高压氧及常规药物治疗,治疗组患者在对照组治疗基础上加用舒血宁注射液、低分子肝素钙治疗,观察两组患者临床疗效、清醒率、意识恢复时间、一氧化碳中毒后迟发性脑病(DEACMP)及不良反应发生情况,比较两组患者治疗前后血液流变学指标、血小板计数(PLT)及活化部分凝血活酶时间(APTT)。结果治疗组患者临床疗效优于对照组,清醒率高于对照组,意识恢复时间短于对照组(P<0.05);治疗前两组患者全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、红细胞比容、红细胞聚集指数、红细胞变形指数比较,差异无统计学意义(P>0.05);治疗后治疗组患者全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、红细胞比容、红细胞聚集指数、红细胞变形指数低于对照组,APTT长于对照组(P<0.05);两组患者治疗后PLT比较,差异无统计学意义(P>0.05);治疗组患者DEACMP发生率为3.7%,低于对照组的18.1%(P=0.004)。结论舒血宁注射液、低分子肝素钙联合高压氧治疗中重度急性CO中毒临床疗效确切,能有效加快患者清醒时间、改善患者血液流变学指标、减少DEACMP的发生。
Objective To observe the clinical effects of Shuxuening injection and low molecular weight heparin calcium combined with hyperbaric oxygen on patients with moderate-severe acute carbon monoxide (CO) poisoning. Methods A total of 152 moderate-severe acute CO poisoning patients admitted to the Third Hospital of Xingtai City, Hebei Province from December 2005 to January 2015 were randomly divided into control group (n = 72) and treatment group (n = 80). Patients in the control group were treated with hyperbaric oxygen and conventional drugs. Patients in the treatment group were treated with Shuxuening injection and low molecular weight heparin calcium on the basis of the control group. Clinical efficacy, awake rate, recovery time, carbon monoxide poisoning Delayed de novo encephalopathy (DEACMP) and incidence of adverse reactions were compared between the two groups before and after treatment of hemorheology, platelet count (PLT) and activated partial thromboplastin time (APTT). Results The clinical efficacy of the treatment group was better than that of the control group, and the awakening rate was higher than that of the control group. The recovery time of consciousness was shorter than that of the control group (P <0.05). The levels of high shear viscosity, low shear viscosity, plasma viscosity , Fibrinogen, hematocrit, erythrocyte aggregation index, erythrocyte deformation index, the difference was not statistically significant (P> 0.05); After treatment, the treatment group patients with high blood viscosity, low blood viscosity, plasma viscosity, Compared with the control group, APTT was longer than that of the control group (P <0.05). There was no significant difference in PLT between the two groups after treatment (P> 0.05). The treatment group The incidence of DEACMP in patients was 3.7%, lower than 18.1% in the control group (P = 0.004). Conclusion Shuxuening injection, low molecular weight heparin combined with hyperbaric oxygen treatment of moderate and severe clinical efficacy of acute CO poisoning, can effectively speed up patients with awake time, improve the patient’s blood rheology indicators, reduce the occurrence of DEACMP.