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目的探讨高压氧联合氨酪酸治疗CO中毒迟发性脑病效果。方法将2010年3月-2012年11月间我院60例CO中毒迟发性脑病患者随机分为参照组与观察组各30例,观察组行高压氧治疗1次/d,同时予以静脉滴注氨酪酸注射液,1g/d,每疗程为2周;参照组行高压氧治疗1次/d,同时予以静脉滴注胞二磷胆碱,0.75g/d,持续2周。观察患者在治疗前后脂质过氧化物、智力水平及两侧大脑中动脉血流阻力指数的改变。结果与治疗前相比,两组患者的智力量表评分升高、P300潜伏期的缩短、血流阻力指数(RI)和丙二醛(MDA)等指标均有不同程度的改善,观察组各指标改善幅度比参照组患者更大,组间差异有统计学意义(P<0.05)。结论高压氧联合氨酪酸治疗CO中毒迟发性脑病能够对其机制的不同环节产生作用,使病变脑组织缺氧和缺血状态得到改变,通过对氧自由基的清除,实现对脑组织的有效保护,值得临床推广。
Objective To investigate the effect of hyperbaric oxygen combined with ammonia butyrate in the treatment of delayed encephalopathy after CO poisoning. Methods Between March 2010 and November 2012, 60 patients with CO-induced delayed encephalopathy in our hospital were randomly divided into control group (30 cases) and observation group (30 cases). The observation group was treated with hyperbaric oxygen for 1 time per day, Note injection of ammonia butyrate, 1g / d, each course of treatment for 2 weeks; hyperbaric oxygen treatment reference group 1 / d, at the same time intravenous citicoline, 0.75g / d, for 2 weeks. The changes of lipid peroxidation, intelligence and blood flow resistance index of middle cerebral artery were observed before and after treatment. Results Compared with those before treatment, the score of intelligence scale, the shortening of P300 latency, the index of RI and MDA in both groups were all improved to some extent. The indexes in the observation group The magnitude of improvement was greater than that of the reference group, with significant differences between groups (P <0.05). Conclusion Hyperbaric oxygen combined with ammonia butyrate treatment of CO poisoning delayed encephalopathy can have different mechanisms of its different parts of the role of the pathological changes in brain tissue hypoxia and ischemia, by the removal of oxygen free radicals to achieve effective on the brain Protection, it is worth clinical promotion.