超早期高压氧干预治疗中重度一氧化碳中毒预防迟发性脑病的效果研究  

Effect of ultra-early hyperbaric oxygen in the prevention of delayed encephalopathy after treatment of moderate-severe 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6期29-31,39,共4页China Modern Medicine

基　　金：广东省珠海市医学科研课题(2015J035)

摘　　要：目的观察超早期应用高压氧干预治疗中重度一氧化碳中毒预防迟发性脑病发生的效果。方法将2014年7月～2015年8月收治的40例符合中重度一氧化碳中毒诊断标准的患者按住院的先后顺序随机分为对照组和观察组各20例,对照组给予吸氧、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,观察组患者除给予对照组治疗外,征求患者及家属同意后,立即进行超早期高压氧干预治疗,观察两组患者治疗前后的临床症状、体征及脑电图情况。结果经过治疗后两组患者的临床症状、体征及脑电图情况较治疗前改善,观察组患者脑电图改善较对照组明显,差异有统计学意义(P<0.05);观察组患者一氧化碳中毒预防迟发性脑病的发病率低于对照组,差异有统计学意义(P<0.01)。结论采用超早期高压氧干预治疗中重度一氧化碳中毒,病变组织缺氧和缺血状态得到改善,有效保护了脑组织,降低了迟发性脑病的发生率,值得临床推广。Objective To observe the effect of ultra-early high pressure oxygen intervention treatment in prevention of delayed encephalopathy after moderate-severe carbon monoxide poisoning. Methods 40 cases of moderate-severe carbon monoxide poisoning treated in our hospital from July 2014 to August 2015 were randomly and equally divided into the control group and the observation group.Patients in the control group were given oxygen,dehydration to reduce intracranial pressure,nourishment of cranial nerves,drugs for cerebral blood circulation improvement,and supportive symptomatic treatment.Patients in the observation group were additionally treated by ultra-early high pressure oxygen intervention based on informed consent.The clinical signs and symptoms and EEG were observed and compared between the two groups before and after treatment. Results The clinical signs and symptoms and EEG were improved after treatment.The improvement of EEG was more significant in the observation group than that in the control group(P<0.05).The incidence of delayed encephalopathy due to carbon monoxide poisoning was significantly lower in the observation group than that in the control group(P<0.01). Conclusion Application of ultra-early high pressure oxygen intervention in treatment of moderate-severe carbon monoxide poisoning can reverse the hypoxic and ischemic status of affected tissues,effectively protect the cerebral tissues,and reduce the incidence of delayed encephalopathy,which is worthy to be promoted.

关 键 词：超早期 高压氧 中重度 一氧化碳中毒 迟发性脑病 

分 类 号：R459.6[医药卫生—治疗学]