舒血宁注射液联合低分子肝素钙与高压氧治疗一氧化碳中毒的效果观察

Clinical effects for the patients with carbon monoxide poisoning by shuxuening injection,low molecular heparin calcium,hyperbaric oxygen

目的:探讨舒血宁注射液联合低分子肝素钙与高压氧治疗一氧化碳中毒的效果。方法:选取2012年11月—2015年6月收治的78例急性一氧化碳中毒患者作为研究对象。按照入院顺序随机均分为观察组和对照组。患者均进行常规治疗,在此基础上,对照组患者采取高压氧舱治疗,观察组患者在对照组治疗的基础上,进行舒血宁注射液联合低分子肝素钙治疗。观察两组患者临床疗效、意识恢复时间、清醒情况、患者治疗前后血小板(PLT)和活化部分凝血活酶时间(APTT)水平变化情况以及血液流变学水平变化情况、不良反应发生情况。结果:观察组治疗总有效率为97.44%,高于对照组的76.92%,差异有统计学意义(P<0.05),观察组患者意识恢复时间低于对照组,差异有统计学意义(P<0.05)。观察组患者<8 h恢复清醒率为58.97%,高于对照组的46.15%,差异有统计学意义(P<0.05),观察组患者治疗后PLT水平低于治疗前,APTT水平高于治疗前,差异有统计学意义(P<0.05),观察组患者治疗后APTT水平高于对照组,差异有统计学意义(P<0.05),观察组患者治疗后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、血细胞比容、红细胞聚集指数、红细胞变形指数均低于对照组和治疗前,差异有统计学意义(P<0.05),观察组患者一氧化碳中毒后迟发性脑病(DEACMP)发生率低于对照组,差异有统计学意义(P<0.05)。两组患者皮下淤斑发生率差异无统计学意义(P>0.05)。结论:舒血宁注射液联合低分子肝素钙与高压氧治疗一氧化碳中毒临床疗效较好,患者意识恢复时间较短,<8 h恢复清醒率较高,PLT和APTT水平恢复较好,血液流变学水平有效改善,DEACMP发生率低,临床应用价值较高。

Objective：To explore the clinical effects for the patients with carbon monoxide poisoning by shuxuening injec-tion,low molecular heparin calcium,hyperbaric oxygen. Methods：All 78 cases of patients with carbon monoxide poisoning were randomly divided into experiment group and control group,they were treated by conventional treatment,on the basis of the con-ventional treatment,the control group were treated by hyperbaric oxygen,on the basis of the control group,the experiment group were treated by shuxuening injection,low molecular heparin calcium. The clinical effects,consciousness recovery time,sober situation,the levels of blood platelet（PLT）,activated partial thromboplastin time（APTT）,blood rheology level were compared. Results ：The total effective rate for the experiment group（ 9 7 . 4 4 % ）were higher than the control group（ 7 6 . 9 2 % ）（ P 〈0. 05）. The consciousness recovery time for the experiment group were lower than the control group（P 〈 0. 05）. The 〈 8 h re-covering rate for the experiment group were higher than the control group（P 〈0. 05）. The levels of PLT after treatment were low-er than before treatment,the levels of APTT after treatment were higher than before treatment and the control group（P 〈0. 05）. The high blood viscosity,low blood viscosity,plasmic viscosity,fibrinogen,hematocrit value,erythro - agglutation index,erythro-cyte deformation index were lower than the control group and before treatment（P 〈 0. 05）. The rate of DEACMP for the experi-ment group were lower than the control group（P 〈 0. 05）. There had no significant difference on the rate of sub dermal ecchy-mosis（P 〉 0. 05）. Conclusion：It has good clinical effects for the patients with carbon monoxide poisoning by shuxuening injec-tion,low molecular heparin calcium,hyperbaric oxygen,consciousness recovery time is shorter,〈 8 h recovering rate is higher, with good levels of PLT and APTT,improve the levels of hemorheology,low rate of DEACMP,it has high values of clinical ap-plication.