亚低温联合高压氧治疗急性一氧化碳中毒的临床效果与安全性研究  

Clinical Efficacy and Safety of Mild Hypothermia Combined with Hyperbaric Oxygen Therapy in the Treatment of Acute Carbon Monoxide Poisoning

作　　者：吴燕生 郑志鹏 郁毅刚[1] WU Yansheng;ZHENG Zhipeng;YU Yigang(Emergency Department of the Ninth Hospital of the Joint Service Support Force of the Chinese People's Liberation Army(Southeast Hospital Affiliated to Xiamen University),Zhangzhou 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九○九医院(厦门大学附属东南医院)急诊科,福建漳州363000

出　　处：《中华灾害救援医学》2024年第11期1249-1252,共4页Chinese Journal of Disaster Medicine

基　　金：2023年福建省自然科学基金项目(2023J011828)。

摘　　要：目的探究亚低温与高压氧对急诊急性一氧化碳中毒(ACOP)患者的治疗效果。方法回顾性分析本院2020年1月至2024年9月收治的100例ACOP患者,按治疗方法不同分为两组。对照组(50例)给予高压氧治疗,观察组(50例)在此基础上给予亚低温治疗。比较两组临床疗效、动脉血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、碳氧血红蛋白(COHb)、氧合血红蛋白(OxyHb)]、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷指数(GCS)、3个月迟发性脑病(DEACMP)发生率、24h血乳酸清除率及不良反应。结果相较于对照组(72.00%),观察组治疗总有效率(96.00%)明显更高(P<0.05);治疗7d后,观察组PaO_(2)水平及OxyHb水平均高于对照组,PaCO_(2)水平及COHb水平均低于对照组,NIHSS评分低于对照组,GCS评分高于对照组,DEACMP发生率低于对照组,24h血乳酸清除率高于对照组,差异均具有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论亚低温联合高压氧对ACOP患者治疗效果显著,可有效改善患者动脉血气指标、神经功能及昏迷程度,降低DEACMP发生率,提高24h血乳酸清除率,且较为安全。Objective Exploring the therapeutic effects of hypothermia and hyperbaric oxygen therapy on emergency acute carbon monoxide poisoning(ACOP)patients.Methods A retrospective analysis was conducted on 100 ACOP patients admitted to our Hospital from January 2020 to September 2024,who were divided into two groups according to different treatment methods.The control group(50 cases)received hyperbaric oxygen therapy,while the observation group(50 cases)received mild hypothermia therapy on this basis.Compare the clinical efficacy,arterial blood gas indicators(PaO_(2),PaCO_(2),COHb,Oxyhemoglobin),National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Index(GCS),3-month incidence of delayed encephalopathy(DEACMP),24-hour lactate clearance rate,and adverse reactions between two groups.Results Compared with the control group(72.00%),the total effective rate of the observation group(96.00%)was significantly higher(P<0.05);After 7 days of treatment,the observation group had higher levels of PaO_(2) and OxyHb than the control group,lower levels of PaCO_(2)and COHb than the control group,lower NIHSS scores than the control group,higher GCS scores than the control group,lower incidence of DEACMP than the control group,and higher 24-hour blood lactate clearance rate than the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of hypothermia and hyperbaric oxygen therapy has a significant therapeutic effect on ACOP patients,which can effectively improve arterial blood gas indicators,neuro logical function,and coma degree,reduce the incidence of DEACMP,improve 24-hour blood lactate clearance rate,and is relatively safe.

关 键 词：一氧化碳中毒 高压氧 亚低温 

分 类 号：R135.14[医药卫生—劳动卫生]