Changes and significance of cerebral oxygen utilization coefficients in patients with acute carbon monoxide poisoning after treatment with Danshen Chuanxiongqin injection combined with ganglioside / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the changes and significance of cerebral oxygen utilization coefficients (O2UCc) in patients with acute carbon monoxide poisoning (ACOP) after treatment with Danshen Chuanxiongqin injection combined with ganglioside.Methods A prospective study was conducted.Two hundreds and six patients with ACOP admitted to the Department of Emergency in Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2011 to January 2016 were enrolled,and they were divided into Danshen Chuanxiongqin group,ganglioside group and Danshen Chuanxiongqin injection combined with ganglioside group (combined treatment group) by random number table.The changes in oxygen saturation of internal carotid artery blood (SaO2) and oxygen saturation of internal jugular vein blood (SjO2) were detected by blood gas analysis for all the patients before and 6 hours,1 day,3 days after treatment,and then according to the rate of oxygen utilization formula [O2UCc=S(a-j)O2/SaO2],O2UCc wascalculated.Before and after treatment,the changes of O2UCc in three groups were compared;after treatment for 14 days,the improvement of clinical symptoms,the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and the 28-day mortality were observed.Results The total therapeutic effective rate of combined treatment group was significantly higher than that in either Danshen Chuanxiongqin injection group or ganglioside group [91.67％ (66/72) vs.77.27％ (51/66),77.94％ (53/68),both P ＜ 0.05].Before treatment,there were no differences in levels of O2UCc among three groups (P ＞ 0.05);after treatment for 6 hours and 1 day,the level of O2UCc in combined treatment group was obviously lower than either that of Danshen Chuanxiongqin injection group or of ganglioside group [6 hours:(38.13±7.95)％ vs.(42.96±7.58)％,(42.30±9.87)％,1 day:(28.42±5.41)％ vs.(33.27±7.53)％,(32.64 ± 6.76)％,all P ＜ 0.05],and the levels of O2UCc at 6 hours and 1 day after treatment had no statistical significant differences between those in Danshen Chuanxiongqin injection group and ganglioside group (P ＞ 0.05);after treatment for 3 days,the percentages of O2UCc levels were very close in Danshen Chuanxiongqin injection group,ganglioside group and combined treatment group [(23.87 ± 6.06)％,(22.38±6.09)％,(23.68 ±4.34)％,respectively,all P ＞ 0.05];The incidence of DEACMP and the 28-day mortality after treatment in combined treatment group were lower than those in Danshen Chuanxiongqin injection group or ganglioside group [the incidence of DEACMP:2.78％ (2/72) vs.12.12％ (8/66),14.71％ (10/68),the 28-day mortality:2.78％ (2/72) vs.13.64％ (9/66),16.18％ (11/68),both P ＜ 0.05];while the incidence of DEACMP and the 28-day mortality after treatment had no statistical significant differences between Danshen Chuanxiongqin injection group and ganglioside group (all P ＞ 0.05).No adverse reactions occurred in the three groups.Conclusion The treatment of Danshen Chuanxiongqin injection combined with ganglioside in treatment of ACOP patients can effectively reduce the O2UCc,decrease the occurrence of DEACMP and 28-day mortality,thus it may improve the prognosis,and the clinical curative effect is distinct.