目的 探討采用復(fù)方麝香注射液聯(lián)合神經(jīng)節(jié)苷脂治療一氧化碳中毒患者的有效性。方法 選取臨西縣人民醫(yī)院2015年12月—2016年12月收治的一氧化碳中毒患者117例，隨機(jī)分成對(duì)照組（58例）和治療組（59例）。對(duì)照組患者靜脈滴注單唾液酸四己糖神經(jīng)節(jié)苷脂鈉注射液，起始劑量為100 mg/d，1次/d，2周后降至40 mg/d，維持4周。治療組在對(duì)照組基礎(chǔ)上靜脈滴注復(fù)方麝香注射液，10 mL加入5%葡萄糖注射液250 mL，1次/d，連續(xù)治療6周。觀察兩組患者臨床療效，比較治療前后兩組患者平均清醒時(shí)間、癥狀消失時(shí)間、12 h乳酸清除率、格拉斯哥昏迷（GCS）評(píng)分、急性生理與慢性健康Ⅱ（APACHE）評(píng)分、神經(jīng)系統(tǒng)損傷率、遲發(fā)性腦病發(fā)生率和病死率。結(jié)果 治療后，對(duì)照組臨床總有效率為81.03%，顯著低于治療組的96.61%；兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者平均清醒時(shí)間、癥狀消失時(shí)間均顯著縮短，12 h乳酸清除率顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者上述指標(biāo)改善情況明顯優(yōu)于對(duì)照組患者（P<0.05）。治療后，兩組患者GCS評(píng)分顯著升高，APACHEⅡ評(píng)分顯著降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組GCS評(píng)分和APACHEⅡ評(píng)分均明顯優(yōu)于對(duì)照組（P<0.05）。治療后，治療組患者神經(jīng)系統(tǒng)損傷率、遲發(fā)性腦病發(fā)生率、病死率均顯著低于對(duì)照組患者，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 復(fù)方麝香注射液聯(lián)合神經(jīng)節(jié)苷脂治療一氧化碳中毒患者療效好，并發(fā)癥少，具有一定的臨床推廣應(yīng)用價(jià)值。

objective To explore the effectiveness of Compound Shexiang Injection combined with ganglioside in treatment of CO poisoning. Methods Patients (117 cases) with CO poisoning in People's Hospital of Linxi County from December 2015 to December 2016 were randomly divided into control (58 cases) and treatment (59 cases) groups. Patients in the control group were iv administered with Monosialotetrahexosylganglioside Sodium Injection, the initial dose was 100 mg/d, once daily, then adjusted to 40 mg/d after 2 weeks, and maintained for 4 weeks. Patients in the treatment group were iv administered with Compound Shexiang Injection on the basis of the control group, 10 mL added into 5% glucose injection 250 mL, once daily, they were treated for 6 weeks. After treatment, the clinical efficacy was evaluated, and the mean waking time, the disappearance time of symptoms, but the 12 h lactate clearance rate, GCS scores, APACHE Ⅱ scores, neurologic impairment rate, delayed encephalopathy rate, and mortality in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.03%, which was significantly lower than 96.61% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the mean waking time, the disappearance time of symptoms in two groups were significantly decreased, 12 h lactate clearance rate was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the GCS scores in two groups were significantly increased, but the APACHEⅡ scores were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the GCS and APACHE Ⅱ scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the neurologic impairment rate, delayed encephalopathy rate, and mortality in the treatment group were obviously lower than those in the control group (P < 0.05). Conclusion Compound Shexiang Injection combined with ganglioside has good curative effect in treatment of CO poisoning with less complications, which has a certain clinical application value.

邢臺(tái)市科技支撐計(jì)劃項(xiàng)目（2015ZC113）