高压氧治疗急性一氧化碳中毒多因素疗效分析  

Analysis on the efficacy of hyperbaric oxygen in the treatment of acute carbon monoxide poisoning by various factors

作　　者：李雁[1] 张天强[1] 周宝英[1] 林侃[1] 

机构地区：[1]福建省立医院高压氧科,福州350001

出　　处：《中华航海医学与高气压医学杂志》2017年第4期305-310,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的观察高压氧对急性一氧化碳中毒患者的疗效，并对其进行多因素疗效分析。方法选取2005年1月至2014年6月在福建省立医院急性一氧化碳中毒患者437例。将所有患者按治疗方法分成2组，对照组予常规治疗，高压氧组在常规治疗基础上高压氧治疗。分别于发病后1个月、半年、1年、2年随访对比疗效积分、痊愈率、有效率、致残率、死亡率和迟发性脑病发病率。对影响急性一氧化碳中毒高压氧治疗疗效的21个影响因素进行相关分析，对有相关性的因素行多重线性回归分析。结果所有患者发病后2年较发病后1个月痊愈率和有效率明显增加，致残率明显降低，差异有统计学意义（P〈0．05）。高压氧组发病后1个月和2年的疗效积分、痊愈率、有效率较对照组明显升高，致残率、死亡率及迟发性脑病发病率较对照组明显降低，差异有统计学意义（P〈0．05）。年龄≤30岁患者行高压氧治疗对发病后1个月和2年疗效积分及迟发性脑病发病率影响不大，但高压氧治疗可降低总迟发性脑病发病率，高压氧治疗间隔时间及治疗次数同迟发性脑病发病有明显的相关性。结论年龄、病因、发病时症状、急诊就诊时间、昏迷时间、高压氧治疗医嘱遵从率、糖尿病病史、CO环境停留时间、高压氧治疗次数等影响因素对疗效和迟发性脑病的发生率影响较大。高压氧治疗急性一氧化碳中毒的临床效果较好，提高了治愈率，降低了迟发性脑病发生率，值得临床推广。Objective To observe the efficacy of hyperbaric oxygen （HBO） in the treatment of acute carbon monoxide poisoning （ACOP） , and also to analyze its treatment efficacy by various factors. Methods Four hundred and thirty-seven patients with ACOP who sought medical care in the Fujian Provincial Hospital from January 2005 to June 2014 were chosen for the study. In accordance with different treatment methods, the patients were divided into 2 groups： the control group （n = 179） and the HBO group （n = 258）. The patients in the control group received routine medical care, while the patients in the （HBO） group received HBO treatment in addition to routine care. Medical follow-ups were made one month, 6 months, 1 year and 2 years after onset, and the scores of therapeutic efficacy, cure rate, efficacy rate, disability rate, death rate, as well as incidence of delayed encephalopathy were analyzed and compared between the 2 groups. Correlation analysis was made of the 21 factors affecting therapeutic efficacy of HBO for the treatment of ACOP, and multiple linear regression analysis of related factors was also made in the study. Results Medical follow-up results indicated that the cure rate and efficacy rate of the patients after 2 years of treatment were significantly better than those patients after just one month of treatment, and the disability rate was also decreased significantly. Statistical significance could be noted, when comparisons were made between the 2 groups （ P 〈 0.05 ）. One month and 2 years after onset, the scores of therapeutic efficacy, cure rates and efficacy rates of the HBO group were significantly higher than those of the control group at the same time points. Disability rates, death rates and incidence of delayed encephalopathy were significantly lower than those of the control group, also with statistical significance （ P 〈 O. 05 ）. There was little effect on the scores of therapeutic efficacy and the incidence of delayed encephalopathy for those HBO patients with an

关 键 词：急性一氧化碳中毒 高压氧治疗 不同年龄段 远期随访 

分 类 号：R595.1[医药卫生—内科学]