复方麝香注射液联合神经节苷脂治疗一氧化碳中毒的疗效观察

Clinical observation of Compound Shexiang Injection combined with ganglioside in treatment of CO poisoning

目的探讨采用复方麝香注射液联合神经节苷脂治疗一氧化碳中毒患者的有效性。方法选取临西县人民医院2015年12月—2016年12月收治的一氧化碳中毒患者117例,随机分成对照组(58例)和治疗组(59例)。对照组患者静脉滴注单唾液酸四己糖神经节苷脂钠注射液,起始剂量为100 mg/d,1次/d,2周后降至40 mg/d,维持4周。治疗组在对照组基础上静脉滴注复方麝香注射液,10 m L加入5%葡萄糖注射液250 m L,1次/d,连续治疗6周。观察两组患者临床疗效,比较治疗前后两组患者平均清醒时间、症状消失时间、12 h乳酸清除率、格拉斯哥昏迷(GCS)评分、急性生理与慢性健康Ⅱ(APACHE)评分、神经系统损伤率、迟发性脑病发生率和病死率。结果治疗后,对照组临床总有效率为81.03%,显著低于治疗组的96.61%;两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者平均清醒时间、症状消失时间均显著缩短,12 h乳酸清除率显著升高,同组比较差异具有统计学意义(P<0.05);且治疗组患者上述指标改善情况明显优于对照组患者(P<0.05)。治疗后,两组患者GCS评分显著升高,APACHEⅡ评分显著降低,同组比较差异具有统计学意义(P<0.05);且治疗组GCS评分和APACHEⅡ评分均明显优于对照组(P<0.05)。治疗后,治疗组患者神经系统损伤率、迟发性脑病发生率、病死率均显著低于对照组患者,两组比较差异具有统计学意义(P<0.05)。结论复方麝香注射液联合神经节苷脂治疗一氧化碳中毒患者疗效好,并发症少,具有一定的临床推广应用价值。

Objective To explore the effectiveness of Compound Shexiang Injection combined with ganglioside in treatment of CO poisoning. Methods Patients（117 cases） with CO poisoning in People＇s Hospital of Linxi County from December 2015 to December 2016 were randomly divided into control（58 cases） and treatment（59 cases） groups. Patients in the control group were iv administered with Monosialotetrahexosylganglioside Sodium Injection, the initial dose was 100 mg/d, once daily, then adjusted to 40 mg/d after 2 weeks, and maintained for 4 weeks. Patients in the treatment group were iv administered with Compound Shexiang Injection on the basis of the control group, 10 m L added into 5% glucose injection 250 m L, once daily, they were treated for 6 weeks. After treatment, the clinical efficacy was evaluated, and the mean waking time, the disappearance time of symptoms, but the 12 h lactate clearance rate, GCS scores, APACHE II scores, neurologic impairment rate, delayed encephalopathy rate, and mortality in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.03%, which was significantly lower than 96.61% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the mean waking time, the disappearance time of symptoms in two groups were significantly decreased, 12 h lactate clearance rate was significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And these indexes in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the GCS scores in two groups were significantly increased, but the APACHE Ⅱ scores were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the GCS and APACHE II scores in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the neurologic impairment rate, delayed encephalopathy rate, and mortality in the treatment group were obviously lower than those in the control group（P〈0.05）. Conclusion Compound Shexiang Injection combined with ganglioside has good curative effect in treatment of CO poisoning with less complications, which has a certain clinical application value.