浅谈高压氧在脑血管疾病患者中发生一氧化碳中毒的治疗对于减少迟发性脑病的意义

Significance of Preventing Delayed Encephalopathy in Cerebrovascular Disease with Carbon Monoxide Poisoning Treated by High Pressure Oxygen

目的探讨高压氧在脑血管疾病患者中发生一氧化碳中毒的治疗对于减少迟发性脑病的意义。方法按照随机数字表法将2018年1月-2021年12月两院收治的56例陈旧性脑梗死及脑梗死恢复期发生一氧化碳中毒患者分为两组,每组28例。对照组因经济或其他个人主观原因仅接受常规对症治疗,观察组在此基础上给予高压氧辅助治疗。比较两组患者治疗效果以及治疗前后氧化应激指标、格拉斯哥昏迷指数(GCS)、美国国立卫生研究院卒中量表(NIHSS)评分、简易智能状态评定量表(MMSE)评分的变化情况,随访3个月,比较迟发性脑病发生率。结果观察组的治疗总有效率高于对照组,随访3个月迟发性脑病发生率低于对照组,数据间对比差异显著(P<0.05);观察组治疗后超氧化物歧化酶(SOD)检测结果高于对照组,神经元特异性烯醇化酶(NSE)检测结果均低于对照组,数据间对比差异显著(P<0.05);观察组治疗后GCS评分、MMSE评分均高于对照组,NIHSS评分低于对照组,数据间对比差异显著(P<0.05)。结论高压氧治疗能够提升脑血管疾病患者发生一氧化碳中毒的治疗预后,预防迟发性脑病,值得临床推荐。

Objective To explore the significance of preventing delayed encephalopathy in cerebrovascular disease with carbon monoxide poisoning treated by high pressure oxygen.Methods 56 cases of patients with chronic cerebral infarction and convalescence of cerebral infarction with carbon monoxide poisoning from January 2018 to December 2021 were randomly divided into observation group(28 cases)and control group(28 cases).The control group only received conventional symptomatic treatment for economic or other personal subjective reasons.The observation group was treated by high pressure oxygen based on the control group.The clinical effect,oxidative stress index,GCS score,NIHSS score,Barthel score and rate of delayed encephalopathy were observed.Results The rate of total effect for the observation group was higher than that of the control group(P<0.05);the rate of delayed encephalopathy for the observation group after 3 months of follow-up was lower than that of the control group(P<0.05);the level of SOD and the scores of GCS,MMSE for the observation group after treatment were higher than those of the control group(P<0.05);the levels of NSE and the score of NIHSS for the observation group after treatment were lower than those of the control group(P<0.05).Conclusion It can can improve the prognosis of carbon monoxide poisoning in patients with cerebrovascular diseases treated by high pressure oxygen.It can prevent the delayed encephalopathy.It is worthy of clinical recommendations.