高压氧治疗对急性一氧化碳中毒合并吸入性肺炎患者康复的影响  

Effect of hyperbaric oxygen therapy on the rehabilitation of patients with acute carbon monoxide poisoning and aspiration pneumonia

作　　者：韩雪迎[1] 焦鹏[2] 宋玉华[3] Han Xueying;Jiao Peng;Song Yuhua(Department of Emergency,First people’s Hospital of Shangqiu,Shangqiu 476100,China;Intensive Care Unit,First People’s Hospital of Shangqiu,Shangqiu 476100,China;Department of Hyperbaric Oxygen,First People’s Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院急诊科,商丘476100 [2]商丘市第一人民医院急诊重症监护室,商丘476100 [3]商丘市第一人民医院高压氧室,商丘476100

出　　处：《中华航海医学与高气压医学杂志》2023年第2期229-233,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191501)。

摘　　要：目的探讨早期高压氧(HBO)治疗对急性一氧化碳中毒(ACOP)合并吸入性肺炎(AP)患者康复的影响。方法回顾性分析2014年2月至2019年5月在商丘市第一人民医院接受HBO治疗(疗程10 d)的100例ACOP合并AP患者的临床资料,根据患者中毒至入院接受HBO治疗时间分为A组(24例,<6 h)、B组(41例,6~12 h)、C组(35例,13~24 h)。疗程结束后采用格拉斯哥昏迷指数(GCS)评估患者昏迷程度;于治疗前、治疗10 d,检测患者炎症指标[降钙素原(PCT)、中性粒细胞与淋巴细胞比值(NLR)]、抗氧化指标[超氧化物歧化酶(SOD)]水平。结果治疗10 d,A组昏迷程度改善情况优于B组、C组,B组改善情况优于C组,差异均有统计学意义(P<0.05);3组治疗前炎症指标、抗氧化指标比较差异无统计学意义(P>0.05);治疗10 d,A组PCT、NLR水平低于B组、C组,SOD水平高于B组、C组,且B组PCT、NLR水平低于C组,SOD水平高于C组,差异均有统计学意义(P<0.05)。结论ACOP合并AP患者尽早接受HBO治疗利于机体康复、改善炎症及抗氧化指标。Objective To explore the effect of early hyperbaric oxygen(HBO)therapy on the recovery of patients with acute carbon monoxide poisoning(ACOP)combined with aspiration pneumonia(AP).Methods A retrospective analysis was performed on the clinical data of 100 patients with ACOP and AP who received HBO treatment from February 2014 to May 2019 in First people's Hospital of Shangqiu.According to the time from poisoning to admission for HBO treatment,the patients were divided into group A(24 cases,<6 h),group B(41 cases,6-12 h),and group C(35 cases,12-24 h);after treatment,the patients were evaluated by the Glasgow Coma Scale(GCS)and were divided into three groups according to the coma severities.Before treatment and 10 days after treatment,the inflammatory indexes of procalcitonin(PCT),the ratio of neutrophil to lymphocyte(NLR),and the antioxidant index of superoxide dismutase(SOD)of the three groups were tested and compared.Results After 10 days of treatment,the improvement of coma severity in the group A was better than those in the groups of B and C,and the improvement of the group B was better than that of the group C,all the differences were statistically significant(P<0.05);before treatment,the differences of the inflammatory indexes and antioxidant index among the three groups were not statistically significant(P>0.05).After 10 days of treatment,the PCT and NLR levels in the group A were lower than those in the groups of B and C,while the SOD level was higher than those in groups of B and C;and the PCT and NLR levels in the group B were lower than those in the group C,while the SOD level was higher than that in the group C,the differences were statistically significant(P<0.05).Conclusion Early HBO combination treatment for patients with ACOP combined with AP is beneficial to the body recovery,inflammation relief,and antioxidant index improvement.

关 键 词：急性一氧化碳中毒 吸入性肺炎 高压氧 支气管肺泡灌洗 昏迷程度 炎症 抗氧化 

分 类 号：R595.1[医药卫生—内科学] R563.1[医药卫生—临床医学]