亚低温联合高压氧对一氧化碳中毒迟发性脑病患者认知功能的影响

Effects of mild hypothermia combined with hyperbaric oxygen on cognitive function in patients with delayed encephalopathy due to carbon monoxide poisoning

目的 观察亚低温联合高压氧疗法对一氧化碳中毒迟发性脑病(DEACMP)患者血清神经元特异性烯醇化酶(NSE)、S100β及认知功能的影响。方法 选取2018年10月至2020年12月河北医科大学第一医院急诊科收治的DEACMP患者70例,按照随机数字表法分为观察组和对照组,每组各35例。两组均给予营养神经、清除自由基及对症治疗等基础上,对照组给予高压氧治疗,观察组给予亚低温+高压氧治疗。对两组进行疗效评估,观察两组治疗前后NSE、S100β水平、认知功能和日常生活能力的变化。结果 治疗3个月后,观察组治疗总有效率高于对照组,差异有统计学意义(P <0.05)。两组治疗后NSE、S100β低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.05)。两组治疗后简易精神状态检查量表、日常生活能力量表评分高于治疗前,且观察组高于对照组,差异有统计学意义(P <0.05)。结论 亚低温联合高压氧治疗DEACMP,能有效保护脑细胞损伤,提高患者认知功能及日常生活能力,改善其生活质量,促进患者的恢复,改善预后,值得临床推广应用。

Objective To observe the effects of mild hypothermia combined with hyperbaric oxygen therapy on neuron specific enolase(NSE), S100β, and cognitive function in patients with delayed encephalopathy due to carbon monoxide poisoning(DEACMP). Methods A total of 70 patients with DEACMP who were admitted to the Department of Emergency of the First Hospital of Hebei Medical University from October 2018 to December 2020 were selected and divided into observation group and control group according to the random number table method, with 35 cases in each group.Both groups were given neurotrophic, free radical scavenging, and symptomatic treatment, the control group was given hyperbaric oxygen therapy, while the observation group was given mild hypothermia + hyperbaric oxygen therapy. The curative effect of the two groups was evaluated, and the changes of NSE, S100β levels, cognitive function, and daily living ability were observed before and after treatment in the two groups. Results After three months of treatment, the total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P < 0.05). After treatment, NSE and S100β in the two groups were lower than those before treatment, while those of the observation group were lower than those of the control group, and the differences were statistically significant(P < 0.05). The scores of the mini-mental state examination scale and the abilities of daily living scale in the two groups after treatment were higher than those before treatment, those of the observation group were higher than the control group, and the differences were statistically significant(P < 0.05). Conclusion Mild hypothermia combined with hyperbaric oxygen therapy for DEACMP can effectively protect brain cell damage, improve patients’ cognitive function and daily living ability, enhance their quality of life, promote patients’ recovery, and improve prognosis, which is worthy of clinical application.