高压氧和抗血小板聚集剂预防一氧化碳中毒迟发脑病

目的 观察高压氧（HBO）和抗血小板聚集剂综合疗法对一氧化碳中毒（COP）迟发脑病的预防效应。方法 中，重度急性一氧化碳中毒患者共401例，随机分成HBO治疗组（HBO）组204例和HBO＋抗血小板聚集剂治疗组（HBO＋抗Pla组）197例。HBO治疗压力0.2MPa，每日1次，共20次，在患者COP后第15，20，25，30，45，60天判定是否出现迟发脑病。结果 COP患者401例中，HBO组204例，出现迟发脑病23例，占11．27％。HB＋抗Pla组197例，出现迟发脑病7例，占3．55％。两组比较差异有非常显著性（P＜0．01）。结论 HBO和抗血小板聚集剂综合治疗急性COP，使其迟发脑病的发生率较单纯HBO治疗明显降低，取得显著的预防效应。

Combined therapy with hyperbaric oxygen and anti-platelet aggregation agent for the prevention of delayed encephalopathy after acute carbon monoxide poisoning

Objective Hyperbaric oxygen(HBO) has long been used to prevent delayed encephalopathy after acute carbon monoxide(CO) poisoning, but its efficacy remains inconsistent. In this study, a clinical observation was made to compare the effectiveness of HBO alone and of combined therapy with hyperbaric oxygen and anti platelet aggregation agent(anti plat). Methods The subjects included 401 patients with moderate to severe acute CO poisoning, which were randomly assigned into one of the two groups:HBO group( n =204) and HBO plus anti plat group( n =197) at the time of admission. Serial evaluations were made on the 15th,20th,25th,30th,45th,60th day after acute CO intoxication. Results Delayed encephalopathy was observed in 11.27 percent of patients in HBO group and in 3.55 percent of patients in HBO plus anti plat group. Conclusions Combined therapy with HBO and anti platelet aggregation agent is much more effective compared with the treatment by HBO alone for the prevention of delayed encephalopathy after acute carbon monoxide poisoning.