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【摘要】:目的:探讨神经节苷脂治疗急性一氧化碳(CO)中毒迟发性脑病(DEACMP)的临床疗效。方法:将60例DEACMP患者随机分为治疗组(30例)和对照组(30例),对照组予高压氧等常规治疗,治疗组在对照组治疗基础上加用神经节苷脂(GM-1)治疗,观察比较两组疗效。结果:治疗组总有效率(90%)高于对照组(67%),两组比较有显著性差异。结论:神经节苷脂治疗急性CO中毒迟发性脑病有显著疗效。
【关键词】:一氧化碳中毒迟发性脑病;神经节苷脂(GM-1);高压氧;疗效
【中图分类号】R135.1+4【文献标识码】A【文章编号】1007-8517(2010)08-007-2
Clinical Effects of Ganglioside on delayed encephalopathy after acute carbon monoxide poisoning
ZHANGLimei,ZHANGZhiqing,Neurology department,Dalian Central Hospital,Dalian 116033
[Abstract] : Objective: To observe the clinical effects of ganglioside GM-l on delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods: 60 patients of DEACMP were randomly and equally divided into the control group and the experiment group.The experiment group was treated with ganglioside while the control group was treated with Piracetam,then compare clinical effects of the two group.Results: The whole effective rate(90%)of experiment group was higher than that of control group. There was significant difference between two groups after treatment.Conclusion:Application of ganglioside treatment had significant clinical effects in delayed encephalopathy after acute carbon monoxide poisoning.
[Key words]:delayed encephalopathy after acute carbon monoxide poisoning (DEACMP);Ganglioside(GM-1);hyperbaric oxygen (HBO);clinical effects
急性一氧化碳中毒迟发性脑病(delayed encephalopathy after acute carbon monoxide poisoning,DEACMP)指急性一氧化碳中毒昏迷病人清醒后,经过一段时间(2～60天)的假愈期,突然出现以意识、精神障碍,锥体外系或锥体系为主的神经精神症状,其病情重、病程长,临床缺乏特效疗法。本文采用神经节苷脂加高压氧治疗DEACMP,取得良好临床疗效,现报告如下。
1资料和方法
1.1一般资料:选取我院近4年门诊及住院急性CO中毒患者60例,均符合DEACMP的诊断标准[1],治疗组30例,男18例、女12例,年龄14～83岁,平均53.7岁,昏迷时间4-48h,假愈期3-61d;对照组30例,男16例、女14例,年龄12～78岁,平均49.5岁,昏迷时间3-45h,假愈期2-63d。两组性别、年龄、昏迷时间、假愈期无显著性差异,具有可比性。
1.2治疗方法
常规治疗:生理盐水250ml+脑活素20ml,每天1次,疗程为14d;地塞米松10mg,每天1次,疗程为5d。
高压氧治疗:每天1次,10d为一个疗程,共3个疗程。
GM-1治疗:生理盐水250ml+GM-1(商品名申捷,齐鲁制药公司生产)80mg,每天1次,疗程为21d。
治疗组:GM-1+高压氧治疗+常规治疗。对照组:高压氧治疗+常规治疗。
治疗前后检测血常规、血糖、血脂、离子及肝肾功能。
1.3疗效标准:痊愈:意识清楚,原有症状体征消失,生活自理,EEG正常;好转:意识障碍程度减轻,原症状体征较前改善,遗留部分运动或精神障碍,EEG轻度到中度异常;无效:治疗后病情处于加重期或稳定期,未进入恢复期,生活不能自理,EEG重度异常。有效包括痊愈和好转。
1.4统计学分析:计数资料采用χ2检验。
2结果
2.1治疗效果两组疗效比较见表1:治疗组总有效率(90%)高于对照组(67%),两组比较有显著性差异(χ2=4.81,P
