河北医科大学学报

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丁苯酞联合依达拉奉对急性一氧化碳中毒迟发性脑病患者精神状态与认知功能的影响

  

  1. 1.河北省唐山市开滦总医院急诊科,河北 唐山 063000;2.河北省唐山市协和医院神经内科,河北 唐山 063000
  • 出版日期:2016-05-25 发布日期:2016-05-20
  • 作者简介:方建飞(1982-),男,浙江兰溪人,河北省唐山市开滦总医院主治医师,医学硕士,从事急诊危重症诊治研究。

Effects of combination of Butylphthalide and edaravone on mental status and cognitive function in delayded encephalopathy after acute carbon monoxide poisoning patients

  1. 1.Department of Emergency, the General Hospital of Kailuan, Tangshan City, Hebei Province,
    Tangshan 063000, China; 2.Department of Neurology,the Hospital of Xiehe,
    Tangshan City, Hebei Province, Tangshan 063000, China
  • Online:2016-05-25 Published:2016-05-20

摘要: [摘要] 目的 探讨丁苯酞联合依达拉奉对急性一氧化碳中毒迟发性脑病( delaydedencepha-lopathyafter
acutecarbonmonoxidepoisoning , DEACMP )患者精神状态与认知功能的影响。方法 选取 100 例 DEACMP 患者,
按随机数字表法分为对照组和观察组各 50 例。对照组采取常规治疗,观察组在常规治疗的基础上联合丁苯酞、依
达拉奉治疗,
2 组均治疗 3 个疗程,疗程结束时评价疗效。治疗前和治疗 1 、 2 、 3 个疗程评定简易智能精神量表
( mini-mentalstateexamination , MMSE ),治 疗 前 和 疗 程 结 束 时 评 定 美 国 国 立 卫 生 研 究 院 卒 中 量 表 ( National
InstitutesofHealthStrokeScale , NIHSS )、 Barthel 指数( Barthelindex , BI )、长谷川痴呆量表( HastgawaDementia
Scale , HDS )。结果 观察组总有效率明显高于对照组(χ
2 =5.741 ,
P <0.05 );治疗后 2 组 MMSE 评分均较治疗前
明显升高,随着疗程的进展, MMSE 评分不断增加,且观察组各时点 MMSE 评分高于对照组,组间、时点间、组间·
时点间交互作用差异均有统计学意义( P <0.05 )。 2 组 NIHSS 评分较治疗前明显降低,
BI 、 HDS 评分均较治疗前
明显升高( P <0.05 );观察组 NIHSS 评分低于对照组,
BI 、 HDS 评分高于对照组( P <0.05 )。结论 丁苯酞联合依
达拉奉治疗 DEACMP 安全、有效,可明显改善患者的精神状态及认知功能障碍,提高患者的日常生活能力及智力
水平,值得在临床上推广应用。

关键词: 一氧化碳中毒, 脑疾病, 丁苯酞, 依达拉奉

Abstract: [
Abstract ] Objective Toinvestigatetheeffectsofcombination ofButylphthalideand
edaravoneonmentalstatusandcognitivefunctionindelayedencephalopathyafteractuecarbon
monoxidepoisoning ( DEACMP ) patients.Methods Atotalof100casesDEACMPpatientswere
randomlydividedintocontrolgroupandobservationgroup , with50casesineachgroup.The
controlgroupofpatientswereappliedconventionaltreatment , theobservationgroupweretreated
withButylphthalideandedaravoneonthebasisofconventionaltreatment.Theefficiencyoftwo
groupswereobservedafter3treatmentcourses.Beforetreatmentandintreatmentcourse1 , 2 ,
3 , the patients were evaluated with simple-mental assessment scale ( mini-mental state
examination , MMSE ) .Beforeandaftertreatment , theefficiencywasevaluatedwithNational
InstitutesofHealthStrokeScale ( NIHSS ), Barthelindex ( BI ) and HasegawaDementiaScale
( HDS ) .Results Theclinicaleffectofobservationgroupwassignificantlybetterthanthatof
controlgroup (χ
2 =5.741 ,
P <0.05 ); MMSEscoreincontrolgroupandinobservationgroupaftertreatment were higherthanthosein groups beforetreatment.Withtheprogressof
treatment , MMSEscorewasincreased.TheMMSEscoreinobservationgroupwashigherthan
thoseincontrolgroupateachtimepoint.Thedifferencewasstatisticallysignificantbetween
groupsanddifferenttime , alsoatdifferenttimepointsinteraction ( P <0.05 ) .TheNIHSSscore
oftheobservationgroupwaslowerthanthoseincontrolgroupateachtimepoint.TheNIHSS
scorewassignificantlylowerthanthoseingroupsbeforetreatment , BIscoresandHDSscores
wassignificantlyincreasedbeforetreatment.NIHSSscoreinobservationgroupwaslowerthan
thoseinthecontrolgroup , BIscoreandHDSscoreswerehigherthanthoseinthecontrolgroup
(
P <0.05 ) .Conclusion ApplicationofButylphthalideandedaravoneinthetreatmentofdelayed
encephalopathyafteracutecarbonmonoxidepoisoningcansignificantlyimprovementalstateand
cognitivedysfunction , alsocanimprovethecognitiveabilityanddailylifeability.Thetreatment
wassafeandeffective , andworthyofpopularizationandapplicationinclinic.