高压氧和中西医结合预防一氧化碳中毒迟发性脑病

Combined therapy of hyperbaric oxygen and integrated traditional Chinese and western medicine for preventing delayed encephalopathy after acute carbon monoxide poisoning

目的:观察高压氧与中西医结合联用防治一氧化碳中毒迟发性脑病的临床疗效。方法:198例中、重度急性一氧化碳中毒患者随机分成高压氧组(102例)和高压氧联合中西医结合(低分子右旋糖酐静脉滴注加服血府逐瘀汤)治疗组(96例)。高压氧治疗压力为0.2MPa,每日1次,共20次。在一氧化碳中毒后15、20、25、30、45和60d判断患者是否出现迟发性脑病。结果:高压氧组102例中13例出现迟发性脑病,占12.75%;高压氧联合中西医结合治疗组96例中4例出现迟发性脑病,占4.17%。结论:高压氧联合中西医结合综合治疗急性一氧化碳中毒,可使患者迟发性脑病的发生率较单纯高压氧治疗明显降低,临床疗效显著。

Objective: To observe the efficacy of hyperbaric oxygen(HBO) combined with integrated traditional Chinese and western medicine(TCM WM) for preventing delayed encephalopathy after acute carbon monoxide(CO) poisoning. Methods: One hundred and ninetyeight patients with moderate to severe acute CO poisoning were randomly assigned into HBO group (n=102), treated with HBO, and group of HBO combined with TCM WM (n=96), treated with HBO, intravenous dextran40 and oral Xuefu Zhuyu decoction(血府逐瘀汤). The pressure of HBO was 0.2 MPa, and the treatment of HBO was once a day for 20 times in both groups. Serial evaluations of delayed encephalopathy were made on the 15 th, 20 th, 25 th, 30 th, 45 th, 60 th day after acute CO intoxication. Results: Delayed encephalopathy was observed in 12.75% of patients in HBO group and in 4.17% of patients in HBO combined with TCM WM group. Conclusion: Combined therapy of HBO and TCM WM is much more effective compared with the treatment by HBO alone for the prevention of delayed encephalopathy after acute CO poisoning.