一氧化碳中毒应用不同氧疗法的疗效观察

Observation on therapeutic effect of different oxygen therapies in the treatment of carbon monoxide poisoning

目的探讨对一氧化碳中毒患者采用不同氧疗方法治疗的临床疗效。方法对我院2011年1月至2013年4月收治的64例一氧化碳中毒患者随机分为观察组和对照组各32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,观察组在常规治疗基础上加用高氧液静脉液体给氧治疗,对照组在常规治疗的基础上加高压氧舱进行治疗。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及治疗后遗症的差异。结果治疗前两组患者的SOD、HBCO、TNF-ɑ、IL-6比较两组间差异不具有统计学意义(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、比较差异不具有统计学意义(P>0.05),TNF-ɑ、IL-6比较差异具有统计学意义(P<0.05)。治疗20天后,两组的疗效分布、总有效率比较差异不具有统计学意义(P>0.05)。两组病死率比较差异不具有统计学意义(P>0.05),两组迟发型脑病、平均昏迷时间比较差异具有统计学意义(P<0.05),观察组的迟发型脑病、平均昏迷时间均显著低于对照组。结论对一氧化碳中毒患者采用高氧液静脉液体给氧治疗与高压氧舱进行治疗的疗效相当,但是治疗后后遗症发生率更低。

Objective To investigate the clinical effect of different oxygen therapies in the treatment of carbon monoxide poisoning. Methods 64 patients with CO poisoning in our hospital from 2011 January to 2013 April were randomly divided into the observation group and the control group,32 cases in each group. All patients were given conventional anti-infection,water and electrolyte balance,measures of respiratory tract nursing. The observation group was additionally treated with high oxygen liquid intravenous therapy,and the control group was given hyperbaric oxygen treatment. The clinical efficacy was compared between the two groups. Results Before the treatment,there was no significant difference in SOD,HBCO,TNF- alpha and IL-6 between the two groups（ P〉0. 05）.After the treatment,the levels of SOD,HBCO,TNF-alpha and IL-6 were all improved（ P〈0. 05）. There were significant differences in IL-6 and TNF-alphathe between the two groups,but there was no significant difference in SOD and HBCO（ P〉0. 05）. 20 days after the treatment,there was no obvious difference in total efficiency and mortality（ P〉0. 05）,but there were statistical significance in delayed encephalopathy and average time of coma（ P〈0. 05）.The incidence of delayed encephalopathy and the average time of coma were significantly lower in the observation group than in the control group. Conclusion The efficacy of high oxygen liquid intravenous therapy and hyperbaric oxygen treatment is similar,but the the former has lower incidence of sequelae.