超早期高压氧治疗老年重度一氧化碳中毒的效果观察  

Effect of ultra-early hyperbaric oxygen in treatment on elderly patients with acute carbon monoxide poisoning

作　　者：董旭[1] 黄博豪[1] 刘侃[1] 朱选平[1] 王欢[1] 毛锐利 

机构地区：[1]遵义医学院第五附属(珠海)医院高压氧科,广东珠海519100

出　　处：《中国当代医药》2016年第16期22-25,共4页China Modern Medicine

基　　金：广东省珠海市卫生和计划生育局基金(2015J035)

摘　　要：目的观察超早期高压氧治疗老年重度一氧化碳中毒的疗效。方法将2014年1月~2015年12月我院收治的60例符合重度一氧化碳中毒诊断标准的老年患者按住院的先后顺序随机分为对照组和观察组,各30例。两组患者入院后均给予吸氧、脱水降颅压、营养脑神经、改善脑血循环药物及支持对症治疗,观察组患者除给予上述治疗外,征求患者及家属同意后,立即进行超早期高压氧干预治疗,治疗后观察比较两组患者治疗前后的临床症状、体征,进行临床神经功能缺损评分评定。结果对照组患者治疗前神经功能缺损程度评分为（35.26±1.34）分,治疗后为（28.37±2.45）分;观察组患者治疗前神经功能缺损程度评分为（34.46±2.23）分,治疗后为（11.25±1.12）分,两组治疗前的神经功能缺损评分比较,差异无统计学意义（P〉0.05）。两组治疗后的神经功能缺损评分显著低于治疗前,差异有统计学意义（P〈0.05）。观察组治疗后的神经功能缺损评分显著低于对照组治疗后,差异有统计学意义（P〈0.01）。治疗后观察组的治疗总有效率高于对照组,平均住院时间短于对照组,迟发性脑病发生率低于对照组,差异有统计学意义（P〈0.05）。结论超早期高压氧治疗老年重度一氧化碳中毒可改变病变组织缺氧和缺血状态,有效保护脑组织,降低迟发性脑病发生率,值得临床推广。Objective To observe the effect of ultra-early hyperbaric oxygen treatment on elderly patients of acute carbon monoxide poisoning.Methods 60 cases of elderly patients with severe carbon monoxide poisoning diagnosis criteria from January 2014 to December 2015 were randomly divided into the control group and the observation group,30 cases in each group.After admission,the patients in the two groups were given oxygen,dehydration reducing intracranial pressure,brain nutrition,improving cerebral blood circulation drugs and symptomatic treatment,the observation group were given above treatment to solicit the consent of patients and their families immediately after ultra early hyperbaric oxygen treatment.After treatment the clinical symptoms and signs,clinical neural function defect score（NDS） between the two groups before and after treatment were observed and compared.Results Before treatment,the NDS of the control group and the observation group respectively were（35.26 ±1.34）,（34.46 ±2.23）scores,after treatment,the NDS of the control group and the observation group were respectively（28.37 ±2.45）,（11.25 ±1.12） scores,there was no significant difference between the two groups before treatment,the scores of neurological deficits after treatment in the two groups was significantly lower than that before treatment respectively,the difference was statistically significant（P 〈0.01）.After treatment,the total effective rate of the observation group was higher than that of the control group,the average hospitalization time was shorter than the control group,the incidence of delayed encephalopathy was lower than that of the control group,the difference was statistically significant（P 〈0.05）.Conclusion Using ultra-early hyperbaric oxygen treatment can improve the hypoxia and ischemia state,effectively protect the brain tissue,reduce the incidence of delayed encephalopathy,worthy of clinical promotion.

关 键 词：超早期 高压氧 老年患者 重度一氧化碳中毒 

分 类 号：R459.6[医药卫生—治疗学]