高压氧治疗急性一氧化碳中毒的疗效及影响因素分析

Analysis of treatment outcomes of hyperbaric oxygentherapy for acute carbon monoxide poisoning and its influencing factors

目的分析急性一氧化碳中毒(ACMP)的高压氧治疗结局及其影响因素。方法回顾性分析2016年1月至2019年1月在该院高压氧室治疗的ACMP患者276例。根据3个月后的随访结果,分为良好结局组和不良结局组,采用单因素分析及二元logistic回归分析影响治疗结局的因素。结果245例(88.8%)患者预后良好,纳入良好结局组;31例(11.2%)患者纳入不良结局组。单因素分析显示,与不良结局组比较,良好结局组年龄偏小[(50.17±18.8)岁vs.(67.4±13.3)岁,P<0.001],两组中毒方式、意识障碍时间、首次高压氧治疗后清醒时间及迟发型脑病发生情况比较,差异有统计学意义(P<0.05)。logistic回归分析显示,高龄(OR=1.066,95%CI:1.016~1.119),首次高压氧治疗后清醒时间延长(OR=4.736,95%CI:2.266~9.895)及迟发性脑病(OR=8.965,95%CI:4.260~25.578)是影响ACMP高压氧治疗预后的危险因素。结论高压氧治疗ACMP疗效明显,高龄、首次高压氧治疗后清醒时间延长及迟发性脑病是影响治疗结局的主要因素。

Objective To analyse the outcomes of hyperbaric oxygen therapy for acute carbon monoxide poisoning(ACMP)and its influencing factors.Methods A retrospective analysis of 276 patients with ACMP treated in the hyperbaric oxygen chamber of this hospital from January 2016 to January 2019 was conducted.According to the outcomes after 3 months follow-up,the patients were divided into the good outcomegroup and the poor outcome group.The univariate analysis and binary logistic regression analysis were use to analyse the influencing factors of outcomes of hyperbaric oxygen therapy.Results A total of 245 cases(88.8%)of patientswith good prognosis were included in the good outcome group,and the other 31 cases(11.2%)of patients were included in the poor outcome group.The results of univariate analysis showed that the age of patients in the good outcome group was younger than that of patients in the poor outcome group[(50.17±18.80)years vs.(67.4±13.3)years,P<0.001].There were statistically significant differences in the manner of poisoning,the time of disturbance of consciousness,the time to wake up after the first hyperbaric oxygentherapy and occurence of delayed encephalopathy between the two groups(P<0.05).Logistic regression analysis showed that the elderly(OR=1.066,95%CI:1.016-1.119),prolonged awake time after the first hyperbaric oxygentherapy(OR=4.736,95%CI:2.266-9.895)and delayed encephalopathy(OR=8.965,95%CI:4.260-25.578)were risk factors for the prognosis of ACMP treated by hyperbaric oxygen therapy.Conclusion Hyperbaric oxygen therapy is an effective method for treating ACMP,and the old age,prolonged awake time after the first hyperbaric oxygentherapy and delayed encephalopathy are the main factors affecting the outcome.