乙酰胺吡咯烷酮联合卡左双多巴治疗急性一氧化碳中毒迟发性脑病疗效观察

摘要

目的 探讨乙酰胺吡咯烷酮联合卡左双多巴治疗急性一氧化碳中毒迟发性脑病的临床疗效.方法 将于我院接受治疗的76例急性一氧化碳中毒迟发性脑病患者随机分为观察组和对照组,每组38例;所有患者均给予高压氧及维生素E等常规治疗,对照组患者在此基础上给予卡左双多巴进行治疗;观察组则在对照组基础上给予乙酰胺吡咯烷酮进行治疗.治疗后评价两组疗效;治疗前后分别采用SF-36表对两组患者精神健康、躯体障碍、活力、社会职能及生理功能等生活质量进行评价,并采用Barthel和BBS法评估患者的运动及协调功能;观察患者治疗期间不良反应的发生情况.结果 治疗后,观察组总有效率为94.7％,显著高于对照组的78.9％ (P ＜0.05);治疗后,观察组患者的精神健康、躯体障碍、活力、社会职能及生理功能评分分别为(67.7±12.2)、(68.3±12.1)、(57.3±8.2)、(61.7±10.4)、(62.6±10.3)分,均明显高于对照组(P＜0.05);治疗后,观察组患者的Barthel和BBS评分分别为(26.3±4.1)、(52.6±6.1)分,改善程度均明显优于对照组(P＜0.05).治疗期间,所有患者均未出现严重不良反应,观察组不良反应发生率与对照组比较差异无统计学意义(P＞0.05).结论 乙酰胺吡咯烷酮联合卡左双多巴治疗急性一氧化碳中毒迟发性脑病疗效确切,安全性较高.%Objective To investigate the clinical effects of acetamide pyrrolidone combined with carbidopa and levodopa controlled-release tablets on delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods Seventy-six patients with DEACMP treated in our hospital were randomly divided into observation group (n =38) and control group (n =38).All patients were treated with hyperbaric oxygen and vitamin E,and control group was treated by carbidopa and levodopa controlled-release tablets,while observation group was given acetamide pyrrolidone on the basis of control group.The efficacy of the two groups was evaluated.Before and after treatment,the SF-36 table was used to evaluate the living quality in the two groups,including mental health,physical barriers,vitality,social functions and physiological functions;Barthel and BBS score were used to evaluate the movement and coordination function in the two groups.The adverse reaction of the two groups was compared during the treatment.Results The total effective rate was 94.7％ in observation group,which was significantly higher than that of control group (78.9％) (P ＜ 0.05).The scores of mental health,physical barriers,vitality,social functions and physiological functions were (67.7±12.2),(68.3 ±12.1),(57.3 ±8.2),(61.7 ±10.4) and (62.6±10.3) in observation group,which were significantly higher than those of control group (P ＜ 0.05).The Barthel and BBS scores were (26.3 ± 4.1) and (52.6 ± 6.1) in observation group,which were improved more significantly than those of control group (P ＜ 0.05).There was no serious adverse reactions in the two groups,and there was no significant difference in the rates of adverse reaction between the two groups (P ＞ 0.05).Conclusion Acetamide pyrrolidone combined with carbidopa and levodopa controlled-release tablets has a good effect in the treatment of DEACMP.