高压氧治疗急性一氧化碳中毒迟发性脑病的疗效观察

Effects of hyperbaric oxygen on delayed encephalopathy after acute carbon monoxide poisoning

目的探讨高压氧治疗急性一氧化碳中毒迟发性脑病（DEACMP）的疗效。方法对112例第四军医大学唐都医院2000年11月至2007年3月住院确诊为DEACMP的患者进行随机分组，对照组采用常规综合治疗36例，治疗组采用综合治疗加高压氧治疗76例，治疗4个疗程后评价其疗效。疗效分为1）痊愈：临床症状体征消失，脑电图恢复正常，生活自理，能胜任日常工作劳动。（2）好转：症状体征部分消失或减轻，脑电图异常程度减轻，生活部分自理，但不能胜任日常工怍。（3）无效：病情无好转或减轻。并对结果进行y0检验与t检验。结果治疗组痊愈62例（81．58％），好转9例（11．84％），无效5例（6．94％），有效率为93．42％；对照组痊愈21例（58．33％），好转5例（13．89％），无效10例（27．78％），有效率为72．22％，治疗组有效率明显高于对照组（P〈0．05）。治愈时间较对照组缩短，差异具有统计学意义（P〈0．05）。结论高压氧治疗可提高急性一氧化碳中毒后迟发性脑病的疗效。

Objective To study the efficacy of hyperbaric oxygen （HO） for the delayed encephalopathy after acute carbon monoxide poisoning （DEACMP） Method One hundred and eleven patients who were diagnozed as the DEACMP from November 2000 to March 2007 in Tangdu Hospital the Fourth Military Medical University were randomly divided into two groups. Thirty-six cases were treated by onventional approach （group A）, and 76 cases by HO besides conventional treatment （group B）. The efficacy of HO was evaluated after 4 courses of treatment. The curative effects were evaluated as （1） cured： clinical symptoms and signs fully disappeared, abnormal electroencephalogram recovered, patients were completely self-help and competent enough for routine work. （2） improved： clinical symptoms and signs partly disappeared, abnormal electroencephalogram partly recovered, patients were partial self-help and incompetent enough for routine work. （3） inefficacy： patient＇ s condition didn＇t changed. Data were expressed as （x ± s） and analyzed with the chi-quare test and t-test. The statistical significance was estabhshed as P 〈 0.05. Results In group B, 62 （81.58 % ） were in good recover, 9 （11.84%） improved and 5 （6.94%） were inefficacy; while in group A： 21 （58.33%） were in good recover, 5 （13.89%） were improved and 10 （27.78%） were inefficacy. The effciency rate in group B was significantly higher （93.42%） than that （72.22%） in group A （P 〈 0.05）, and the required time for the therapeutic effect noticed time in group B were significantly shorter （ P 〈 0.05） Conclusions HO can improve the therapeutic effects on DEACMP .