高压氧联合丁苯酞及依达拉奉治疗急性CO中毒的疗效观察  

Observation of the effect of hyperbaric oxygen combined with butylphthalide and edaravone on the patients with acute CO poisoning

作　　者：万百艳 朱颉[1] WAN Baiyan;ZHU Jie(Hyperbaric oxygen therapy room,Department of Emergency,Shenshan Medical Center,Memorial Hospital of Sun Yat-sen University,Shanwei 516600,China)

机构地区：[1]中山大学孙逸仙纪念医院深汕中心医院急诊科高压氧治疗室,广东汕尾516600

出　　处：《中国处方药》2025年第3期86-89,共4页Journal of China Prescription Drug

摘　　要：目的分析24 h内紧急高压氧联合丁苯酞及依达拉奉治疗对急性一氧化碳(CO)中毒患者迟发性脑病(DEACMP)发生率的影响。方法纳入2022年12月~2024年3月期间中山大学孙逸仙纪念医院深汕中心医院急诊科收治的60例急性CO中毒患者进行回顾性分析,将其中以24 h内紧急高压氧治疗联合依达拉奉治疗的30例患者纳入对照组,以24 h内紧急高压氧治疗联合依达拉奉及丁苯酞治疗的30例患者纳入联合组。比较治疗前、治疗3 d后两组患者氧合情况[碳氧血红蛋白(COHb)、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))]、炎症因子水平[中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)]、心肌损伤指标水平[肌酸激酶同工酶(CK-MB)、心肌钙蛋白(cTnT)]。比较两组患者24 h血乳酸清除率、DEACMP发生率。结果治疗3d后,两组患者COHb、PaCO_(2)、CRP、NLR、CK-MB、cTnT水平显著低于治疗前,且两组间比较,联合组更低(P<0.05);SaO2水平显著高于治疗前,且两组间比较,联合组更高(P<0.05)。相较于对照组,联合组患者24 h血乳酸清除率略高(86.67%vs.80.00%),DEACMP发生率略低(46.67%vs.23.33%)(P>0.05)。结论CO中毒后24 h内紧急使用高压氧联合丁苯酞及依达拉奉治疗效果显著,可缓解患者炎症反应,减少心肌细胞损伤,降低DEACMP发生率。Objective To investigate the impact of emergency hyperbaric oxygen within 24 hours,in combination with butylphthalide and edaravone,on the incidence of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)in patients suffering from acute carbon monoxide(CO)poisoning.Methods Sixty patients with acute CO poisoning who were included in the emergency department of Shenshan Medical Center of Memorial Hospital of Sun Yat-sen University from December 2022 to March 2024 were retrospectively analyzed,and 30 patients who received emergency hyperbaric oxygen therapy within 24 h combined with edaravone were included in the control group.Thirty patients who received emergency hyperbaric oxygen therapy within 24 h combined with edaravone and butylphthalein were included in the combination group.The oxygenation status[carbon hemoglobin(COHb),arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SaO_(2))],inflammatory factors[neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP)]and myocardial injury indicators[creatine kinaseisoenzyme(CK-MB),cardiac troponin I(cTnI)]before treatment and after 3 days of treatment,24 h blood lactate clearance rate and incidence rate of DEACMP were compared between groups.Results After 3 days of treatment,the levels of COHb,PaCO_(2),CRP,NLR,CK-MB and cTnT in both groups significantly decreased compared to pre-treatment levels.Additionally,the combined group exhibited even lower levels(P<0.05).The SaO_(2) level significantly increased post-treatment,with the combined group showing a higher increase(P<0.05).Compared with the control group,the combined group had a slightly higher of blood lactic acid clearance(86.67%vs.80.00%)and a slightly lower incidence of DEACMP at 24 h(46.67%vs.23.33%)(P>0.05).Conclusion Emergency hyperbaric oxygen therapy within 24 hours following CO poisoning,in combination with butylphthalide and edaravone,has demonstrated a significant therapeutic effect.This treatment approach is effective in alleviate the inflammatory response,redu

关 键 词：丁苯酞 依达拉奉 高压氧 一氧化碳中毒 迟发性脑病 

分 类 号：R74[医药卫生—神经病学与精神病学]