缩短门-高压氧治疗时间是减少一氧化碳中毒迟发性脑病发生率的关键因素

Shortening the time of door to hyperbaric oxygen treatment is the key factor to reduce the incidence of delayed encephalopathy after acute carbon monoxide poisoning

目的分析急性一氧化碳中毒(ACOP)患者发生迟发性脑病(DEACMP)的危险因素,探索减少DEACMP发生率的有效措施。方法采用回顾性分析方法,收集2016年1月—2020年2月在徐州医科大学附属医院急救中心住院的ACOP患者的临床和检验资料,根据发病3个月内是否发生DEACMP进行分组(DEACMP组和非DEACMP组)和统计分析。结果共有111名患者符合纳入排除标准,其中32例发生DEACMP,发生率为28.8%。两组患者的年龄、职业(是否从事体力劳动)、发现中毒到高压氧治疗时间、昏迷持续时间、入院第一天WBC水平等指标的差异有统计学意义(P<0.05);logistic回归分析提示上述因素是发生DEACMP的独立危险因素。结论高龄、从事体力劳动者、发病到治疗的时间较长者、昏迷时间较长者、发病早期WBC计数增高明显者是DEACMP发生的独立危险因素,缩短门-高压氧治疗时间是目前减少DEACMP发生率的最有效措施。

Objective To analyze the risk factors of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)in patients with acute carbon monoxide poisoning(ACOP)and explore the effective measures to reduce the incidence of DEACMP.Methods Retrospective analysis method was used to collect clinical and laboratory data of ACOP patients hospitalized in Affiliated Hospital of Xuzhou Medical University from January 2016 to February 2020.Based on the occurrence of DEACMP within 3 months,statistical analysis was performed in groups(DEACMP group and non-DEACMP group).Results A total of 111 patients met the inclusion and exclusion criteria,and 32 of them developed DEACMP,with an incidence of 28.8%.There were statistically significant differences between the two groups in terms of age,occupation(whether engaged in manual labor),time from poisoning to hyperbaric oxygen treatment,duration of coma,WBC level on the first day of admission,etc.(P<0.05).Conclusion Age,whether engaged in physical work,time from onset to hyperbaric oxygen therapy,coma time,and WBC elevation were independent risk factors for DEACMP.Shortening the time of door to hyperbaric oxygen treatment,inhibiting the inflammatory response,and carrying out memory training as early as possible may be effective ways to prevent DEACMP.