一氧化碳中毒肺部感染患者甲襞微循环及脑血流变化研究  

Study on the change of nailfold microcirculation and cerebral blood flow in patients with carbon monoxide poisoning and pulmonary infections

作　　者：尤莉[1] 刘志宁[2] 刘晓晖 雷彬 李颖[1] 

机构地区：[1]唐山市工人医院急诊内科,河北唐山063000 [2]唐山市工人医院急救中心,河北唐山063000 [3]唐山市工人医院体检中心,河北唐山063000 [4]唐山市工人医院中心采血室,河北唐山063000

出　　处：《中华医院感染学杂志》2015年第11期2447-2449,共3页Chinese Journal of Nosocomiology

基　　金：河北省科学技术支撑计划基金资助项目(11276103d-90)

摘　　要：目的研究及观察一氧化碳中毒并发肺部感染患者甲襞微循环及脑血流状态的变化,为其制定治疗干预措施提供依据。方法选取2009年10月-2013年12月在医院进行治疗的235例一氧化碳中毒患者为研究对象,将235例患者根据是否发生肺部感染分为一氧化碳中毒组(A组)160例和一氧化碳中毒肺部感染组(B组)75例,将两组患者的甲襞微循环及脑血流指标进行检测与比较,对B组中不同感染程度者的检测水平进行统计与比较。结果 B组的管襻积分、襻周状态积分及管襻畸形率、白微栓率分别为(1.29±0.15)分、(1.95±0.24)分及(35.46±3.27)%、(1.98±0.25)%,均高于A组的(0.75±0.10)分、(1.02±0.14)分及(19.33±2.15)%、(1.31±0.14)%,差异有统计学意义(P<0.05);B组的大脑中动脉Vs及Vd指标,分别为(0.75±0.05)m/s及(0.27±0.04)m/s,均低于A组的(1.08±0.09)m/s及(0.56±0.06)m/s,而PI及RI指标则高于A组,差异均有统计学意义(P<0.05)。结论一氧化碳中毒并发肺部感染患者甲襞微循环及脑血流呈现异常的状态,且微循环受感染严重程度的影响较大,因此应重视对该类患者进行甲襞微循环及脑血流的改善。OBJECTIVE To study and observe the change situation of nailfold microcirculation and cerebral blood flow in patients with carbon monoxide poisoning complicated with pulmonary infections ,so as to provide evidence for the intervention measure of treatment .METHODS Totally 235 patients with carbon monoxide poisoning in our hospital from Oct .2009 to Dec .2013 were selected as research subjects ,and the 235 patients were divided into group A （carbon monoxide poisoning ）of 160 cases and group B （carbon monoxide poisoning complicated with pulmonary infection ） of 75 cases according to the presence of pulmonary infections ,then the nailfold microcirculation and cerebral blood flow indexes of two groups were detected and compared ,and the detection indexes of patients in group B with different infection degrees were analyzed and compared . RESULTS The capillary loop score , the around‐loop status score , the malformation rate of capillary loop and the white microthrombi rate was respectively （1 .29 ± 0 .15）points ,（1 .95 ± 0 .24）points ,（35 .46 ± 3 .27）% ,and （1 .98 ± 0 .25）% in group B ,significently higher than （0 .75 ± 0 .10）points ,（1 .02 ± 0 .14）points ,（19 .33 ± 2 .15）% , and （1 .31 ± 0 .14）% in group A （P〈0 .05） .The cerebral arterial Vs and Vd was （0 .75 ± 0 .05）m/s and （0 .27 ± 0 .04）m/s in group B ,significently lower than （1 .08 ± 0 .09）m/s and （0 .56 ± 0 .06）m/s in group A ,however ,the PI and RI indexes in group B were significently higher than in group A （P〈0 .05） .CONCLUSION The nailfold microcirculation and the cerebral blood flow in patients with carbon monoxide poisoning complicated with pulmona‐ry infections were in abnormal state ,and the influence of infections on the microcirculation is great ,therefore ,the improvement of the nailfold microcirculation and cerebral blood flow should be paid more attention to .

关 键 词：一氧化碳中毒 肺部感染 甲襞微循环 脑血流 

分 类 号：R181.32[医药卫生—流行病学]