一氧化碳中毒不同时段高压氧治疗的疗效分析

Clinical analysis of hyperbaric oxygen therapy in the treatment of carbon monoxide poisoning at different times

目的探讨对一氧化碳中毒患者采用高压氧治疗的不同时机对治疗效果的影响。方法对我院2011年1月至2013年4月收治的84例一氧化碳中毒患者随机分为观察组和对照组各42例,两组采用常规的抗感染、水电解质平衡、呼吸道护理措施进行治疗,观察组在一氧化碳中毒12 h内就进行高压氧治疗,对照组在一氧化碳中毒12 h后进行高压氧治疗。比较两组患者治疗20天后的临床疗效、超氧化物歧化酶(SOD)、碳氧血红蛋白(HBCO)、TNF-ɑ、IL-6及治疗后相关后遗症发生率的差异。结果治疗前两组患者的SOD、HBCO、TNF-ɑ、IL-6比较不具有统计学意义(P>0.05);治疗后两组的SOD、HBCO、TNF-ɑ、IL-6与治疗前进行组内比较差异具有统计学意义(P<0.05),治疗后两组各种临床指标均显著好转;治疗后两组间SOD、HBCO、TNF-ɑ、IL-6比较差异具有统计学意义(P<0.05)。治疗后两组患者的疗效分布、总有效率比较差异均不具有统计学意义(P>0.05)。治疗过程中,观察组的平均昏迷时间、迟发性脑病发生率显著低于对照组且差异具有统计学意义(P<0.05);两组病死率比较差异不具有统计学意义(P>0.05)。结论本研究发现在发生一氧化碳中毒后12 h内进行高压氧治疗能够有效降低治疗后迟发型脑病的发生率。

Objective To investigate the clinical effect of hyperbaric oxygen therapy in the treatment of carbon monoxide poisoning at different times. Methods 84 patients with carbon monoxide poisoning were randomly divided into the observation group and the control group, 42 cases in each group. All of them were given conventional anti-infection, water-electrolyte balance, and respiratory tract nursing. The observation group was given hyperbaric oxygen therapy within 12 hours after carbon monoxide poisoning, and the control group was given hyperbaric oxygen therapy 12 hours after carbon monoxide poisoning. The clinical efficacy and the levels of SOD, HBCO, IL-6 and TNF-α were comparatively analyzed. Results There was no significant difference in SOD, HBCO, TNF-α and IL-6 between the two groups before the treatment （ P 〉 0. 05）. After the treatment, the levels of SOD, HBCO,TNF-α and IL-6 improved significantly, and the improvement was more pronounced in the observation group than in the control group （P 〈 0. 05）. The total effective rate showed no statistically significance between the two groups （ P 〉 0. 05 ）. During the course of treatment, the average time of coma and the incidence of delayed encephalopathy were significantly lower in the observation group than in the control group （P 〈 0. 05）. Conclusion Hyperbaric oxygen therapy can effectively reduce the incidence of delayed encephalopathy in the treatment of patients with carbon monoxide poisoning with 12 hours after poisoning.