陆 岩，方建飞，王 芳，罗晓燕，李 伟

（河北省开滦总医院，河北 唐山 063000）

醒脑静联合乙酰谷酰胺治疗急性重度一氧化碳中毒4 5例临床观察

陆 岩，方建飞，王 芳，罗晓燕，李 伟

（河北省开滦总医院，河北 唐山 063000）

目的探讨醒脑静联合乙酰谷酰胺治疗急性重度一氧化碳中毒的临床疗效。方法 选择医院2012年1月至2017年1月收治的急性重度一氧化碳中毒患者90例，按随机数字表法分为对照组和观察组，各45例。两组患者均给予高压氧舱、营养神经、甘露醇脱水降颅压和改善循环等基础治疗，对照组患者在此基础上给予乙酰谷酰胺静脉滴注，观察组在对照组治疗基础上给予醒脑静静脉滴注。结果 观察组总有效率为93．33%，显著高于对照组的75．56%（P＜0．05）；治疗后，两组患者格拉斯哥昏迷评分（GCS）和血清超氧化物歧化酶（SOD）水平均明显升高，且观察组升高更显著（P＜0．05）；观察组患者迟发性脑病发生率为4．44%，显著低于对照组的22．22%（P＜0．05）。结论 醒脑静联合乙酰谷酰胺治疗急性重度一氧化碳中毒疗效显著，能有效改善患者的临床表现，促进患者意识恢复，升高血清SOD水平，减少迟发性脑病的发生，值得临床推广。

醒脑静；乙酰谷酰胺；急性重度一氧化碳中毒；临床疗效

Abstract：Objective To investigate the clinical effect of Xingnaojing combined with acetylglutamide in the treatment of acute severe carbon monoxide poisoning．M ethods A total of 90 patients with acute severe carbon monoxide poisoning admitted to our hospital from January 2012 to January 2017 were selected and divided into the control group（n＝45）and the observation group（n＝45）according to random number table method．The two groups were treated with hyperbaric oxygen，nutrition nerve，mannitol dehydration to reduce intracranial pressure and improve circulation and other basic treatment，on this basis，the control group was treated with acetylglutamide，while the observation group was additionally treated with Xingnaojing on the basis of the control group．Resu lts The total effective rate of the observation group was 93．33%，which was significantly higher than 75．56% of the control group（P＜0．05）．After treatment，the GCS score and serum SOD level were significantly increased in the two groups，and the observation group was increased more significantly（P＜0．05）．The incidence rate of delayed encephalopathy of the observation group was 4．44%，which was significantly lower than 22．22% of the control group（P ＜0．05）．Conclusion Xingnaojing combined with acetylglutamide is effective in the treatment of patients with severe acute carbon monoxide poisoning，and it also can reduce the incidence of delayed encephalopathy，which is worthy of clinical promotion．

Key words：Xingnaojing；acetylglutamide；severe acute carbon monoxide poisoning；clinical effect

急性一氧化碳中毒是吸入较高浓度一氧化碳后引起的急性缺氧性脑病，部分患者会有迟发性神经精神症状或其他脏器的缺氧性改变，发病人数和死亡人数均居我国急性职业性化学物中毒前列，危害很大[1－2]。其严重程度不仅与空气中一氧化碳浓……