不同高压氧治疗方案对急性一氧化碳中毒受损心肌的疗效分析  

Effects of different hyperbaric oxygen treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning

作　　者：秦军[1] 池洪伟[1] 秦红燕[1] 孙熙璇[1] 石磊[1] 李厚成[2] 

机构地区：[1]聊城市人民医院,山东省聊城252000 [2]湖北医药学院附属太和医院高压氧科

出　　处：《中华航海医学与高气压医学杂志》2011年第2期93-95,共3页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨不同高压氧（hyperbaric oxygen，HBO）治疗方案对急性一氧化碳（carbon monoxide，CO）中毒受损心肌的影响。方法对2006年10月至2010年3月收治的155例重症CO中毒患者进行HBO常规治疗（常规组，75例）和HBO改进治疗（改进组，80例）。（1）常规组治疗方案：治疗压力0．25MPa，加压20min，稳压后吸氧2次，每次30min，中间间歇10min，减压20min出舱。每日1次，12次为1个疗程，治疗9～68次。（2）改进组方案：前5d采用HBO常规治疗，以后采用减小治疗压力、缩短吸氧时间、增加吸氧间隔、间歇给氧的治疗方案，治疗压力0．20MPa，稳压吸氧4次，每次10min，中间间歇5min，减压20min出舱。连续治疗3d后间隔1d，10d为1个疗程。2组患者使用相同的药物治疗方案。统计分析常规组和改进组ST—T变化及血清心肌酶变化。结果改进组与常规组相比ST—T恢复率（56％，28％）明显升高（P〈0．05），HBO治疗第3天和第6天ST-T加重率（第3天21％、25％，第6天16％、27％）明显降低（P〈0．01）；2组血清心肌酶恢复率和加重率比较差异有统计学意义（P〈0．05，P〈0．01）。结论HBO改进方案对CO中毒患者受损心肌疗效较好。Objective To investigate the effects of different hyperbaric oxygen （HBO） treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide （CO） poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group （the routine group,75 cases） and the improved HBO treatment group （the improved group, 80 cases）. The treatment profile of the routine HBO treatment group ： the patients were compressed for 20 min to the treatment pressure of O. 25 MPa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 rain plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group： the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure （0.20 MPa） , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen- breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 rain. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased （56% ,28% ）obviously, when compared with that of the routine HBO treatment group（P 〈 0. 05）. ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days （21% and 25% on the 3rd day, 16% and 27% on the 6th day） respectively（P 〈0.01）. Statistical di

关 键 词：高压氧 一氧化碳中毒 心肌损伤 

分 类 号：R595.1[医药卫生—内科学]