纳美芬联合高压氧治疗急性一氧化碳中毒临床疗效观察

Clinical Observation of Nalmefene Combined with Hyperbaric Oxygen in the Treatment of Acute Carbon Monoxide Poisoning

目的探讨在急性一氧化碳中毒患者中应用纳美芬联合高压氧治疗的临床治疗效果。方法选取2015年1月—2018年12月该院收治的50例急性一氧化碳中毒患者,按照数字随机表法分为试验组和对照组,每组25例,对照组采用高压氧治疗方法,试验组采用纳美芬联合高压氧治疗方法,比较两组的治疗效果,迟发性脑病和并发症发生率,以及MoCA和MMSE水平。结果治疗前,两组患者MoCA评分、MMSE评分差异无统计学意义(P>0.05),治疗后,试验组MoCA评分(29.15±4.26)分、MMSE评分(24.15±3.26)分均高于对照组(t=5.294,8.978,P<0.05),试验组患者总有效率96.00%明显高于对照组76.00%(χ^2=4.153,P<0.05),试验组迟发性脑病0.00%和并发症发生率8.00%明显低于对照组(χ^2=4.348,4.500,P<0.05)。结论纳美芬联合高压氧治疗急性一氧化碳,治疗效果明显,迟发性脑病发生率低,降低并发症发生率,改善患者认知水平和精神状态,安全可靠,因此可临床推广应用。

Objective To investigate the clinical effect of nalmefene combined with hyperbaric oxygen therapy in patients with acute carbon monoxide poisoning.Methods Fifty patients with acute carbon monoxide poisoning admitted to our hospital from January 2015 to December 2018 were enrolled in the study.The patients were divided into the experimental group and the control group according to the numerical random table method.25 patients in the control group were treated with hyperbaric oxygen therapy.The experimental group was treated with nalmefene combined with hyperbaric oxygen therapy to compare the therapeutic effects of the two groups,the incidence of delayed encephalopathy and complications,and the levels of MoCA and MMSE.Results Before treatment,there was no significant difference in MoCA score and MMSE score between the two groups (P>0.05).After treatment,the MoCA score (29.15±4.26)points and MMSE score (24.15±3.26)points were higher in the experimental group than in the control group (t=5.294,8.978,P<0.05),the total effective rate of the experimental group was 96.00% significantly higher than the control group 76.00%(χ^2=4.153,P<0.05),the experimental group had delayed encephalopathy 0.00% and the complication rate was 8.00% was significantly lower than the control group (χ^2=4.348,4.500,P<0.05).Conclusion Nalmefene combined with hyperbaric oxygen therapy for acute carbon monoxide has obvious therapeutic effect,low incidence of delayed encephalopathy,lower the incidence of complications,improve the cognitive level and mental state of patients,and it is safe and reliable,so it can be applied clinically.