高压氧联合大剂量神经节苷脂治疗一氧化碳中毒后迟发性脑病效果观察

目的探讨高压氧联合大剂量神经节苷脂治疗一氧化碳中毒后迟发性脑病的临床效果。方法（1）一氧化碳中毒后迟发性脑病患者随机分成治疗组（37例）和对照组（35例）。对照组患者均予高压氧等常规治疗，治疗组在给予高压氧等常规治疗的基础上给予大剂量神经节苷脂100mg，每天1次，疗程为20—30d。所有患者在治疗前后均进行脑电图检查、简易痴呆量表评分。结果对照组脑电图异常率65．71％（23／35），治疗组为37．83％（14／37），有明显降低（χ^2=5．60，P〈0．05）。治疗组治疗前后简易痴呆量表评分分别为（15．45±2．93）、（23．70±2．13）分，对照组分别为（14．88±2．84）、（20．33±2．09）分。两组治疗前后比较，治疗后比治疗前简易痴呆量表评分有不同程度的提高（t值分别为3．18、2．91，P均〈0．05）；而治疗组在治疗后简易痴呆量表评分提高更明显（χ^2=6．28，P〈0．05）；治疗组有效率为86．48％（32／37），明显高于对照组51．43％（20／35）（χ^2=7．72，P〈0．01）。结论高压氧联合大剂量神经节昔脂治疗一氧化碳中毒后迟发性脑病效果明显，优于高压氧常规药物治疗。

Clinical effects of ganglioside on delayed encephalopathy after acute carbon monoxide poisoning.

Objective To observe the clinical effects of hyperbaric oxygen combined large dose ganglioside on delayed encephalopathy after acute carbon monoxide poisoning （DEACMP）. Methods A totol of 72 patients of DEACMP were randomly divided into the observation group（37）and the control group（35 ）. The patients of control group were given the routine treatment with hyperbaric oxygen. In the treatment group patients were given large doses of gangliosides 100 mg, 1 times a day, for a period of 20 to 30 days additionally to the routine treatment of hyperbaric oxygen. All patients were examined before and after treatment in EEG examination （ EEG ）, mini-mental state examination（ MMSE ）. Results The abnormal rate of EEG was 37.83 % （ 14/37 ） in the control group, which was significantly lower than that of 65.71% （23/35） in the treatment group（ χ^2 = 5.60,P 〈0.05）. In the treatment group, the MMSE was （ 15.45 ±2.93） and （23.70 ±2.13） before and after treatment, respectively; in the control group, the MMSE was （ 14.88 ± 2.84） and （20.33 ± 2.09） before and after treatment. The MMSE was significantly impoved after treatment in both group （t =3.18 and 2.91, Ps 〈 0.05 ）. Furthermore, the MMSE impoved more significantly in the treatment group compared to the control group （t =6.28 ,P 〈 0.05 ）. The effective rate of treatment group was 86.48% （32/37）, which was significantly higher than that of 51.43% （20/35） in the control group （ χ^2 = 7.72, P 〈 0.01 ）. Conclusion Application of large dose ganglioside treatment had significant clinical effects in delayed encephalopathy after acute car-bon monoxide poisoning, which is better than the effect of routine hyperbaric oxygen treatment.