目的：探究低分子肝素联合奥扎格雷钠治疗急性一氧化碳中毒迟发性脑病的临床疗效。方法选取2010年12月—2014年12月三峡大学仁和医院收治的72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36例。对照组患者采用常规治疗，观察组患者在常规治疗基础上加用低分子肝素和奥扎格雷钠治疗，两组患者均治疗14 d。比较两组患者临床疗效、不良反应发生情况，治疗前后活化部分凝血活酶时间（ APTT）、凝血酶原时间（ PT）、凝血酶时间（ TT）及纤维蛋白原（ FIB）、抗凝血酶-Ⅲ（ AT-Ⅲ）水平。结果观察组患者临床疗效优于对照组（u=3.084，P=0.002）。治疗前两组患者APTT、PT、TT及FIB、AT-Ⅲ水平比较，差异无统计学意义（P>0.05）；治疗后观察组患者APTT、PT、TT长于对照组，AT-Ⅲ水平高于对照组，FIB水平低于对照组（ P<0.05）。观察组患者不良反应发生率为5.6%，对照组患者不良反应发生率为2.8%；两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论低分子肝素联合奥扎格雷钠治疗急性一氧化碳中毒迟发性脑病的临床疗效确切，能有效改善患者凝血指标，且不良反应轻微。%Objective To investigate the clinical effect of low molecular heparin combined with ozagrel sodium on delayed encephalopathy after acute carbon monoxide poisoning. Methods A total of 72 patients with delayed encephalopathy after acute carbon monoxide poisoning were selected in Zhongnan Hospital of Wuhan University from December 2010 to December 2014,and they were randomly divided into control group and observation group,each of 36 cases. Patients of control group received conventional treatment,while patients of observation group received low molecular heparin combined with ozagrel sodium based on the conventional treatment,both groups treated for 14 days. Clinical effect,incidence of adverse reactions,APTT, PT,TT,FIB and AT-Ⅲ before and after treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group(u =3. 084,P =0. 002). No statistically significant differences of APTT,PT,TT,FIB or AT-Ⅲwas found between the two groups before treatment(P>0. 05);after treatment,APTT,PT,TT of observation group were statistically significantly longer than those of control group,AT -Ⅲ of observation group was statistically significantly higher than that of control group,while FIB of observation group was statistically significantly lower than that of control group ( P<0. 05 ). The incidence of adverse reactions of observation group was 5. 6%, that of control group was 2. 8%, the difference was not statistically significantly different ( P >0. 05 ). Conclusion Low molecular heparin combined with ozagrel sodium has certain clinical effect on delayed encephalopathy after acute carbon monoxide poisoning,which can effectively improve the blood coagulation index with mild adverse reactions.
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