[1]张杨,李翠红,杜晓芹,等.高压氧治疗介入时机对中重度急性一氧化碳中毒患者预后的影响[J].第三军医大学学报,2020,42(05):523-527.
 ZHANG Yang,LI Cuihong,DU Xiaoqin,et al.Effect of timing of hyperbaric oxygen therapy on prognosis of patients with acute moderate to severe carbon monoxide poisoning[J].J Third Mil Med Univ,2020,42(05):523-527.
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高压氧治疗介入时机对中重度急性一氧化碳中毒患者预后的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第05期
页码:
523-527
栏目:
临床医学
出版日期:
2020-03-15

文章信息/Info

Title:
Effect of timing of hyperbaric oxygen therapy on prognosis of patients with acute moderate to severe carbon monoxide poisoning
作者:
张杨李翠红杜晓芹谢全张加莉李帅明崔高宇冯华储卫华
陆军军医大学(第三军医大学)第一附属医院神经外科
Author(s):
ZHANG Yang LI Cuihong DU Xiaoqin XIE Quan ZHANG Jiali LI Shuaiming CUI Gaoyu FENG Hua CHU Weihua

Department of Neurosurgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
一氧化碳中毒高压氧治疗介入时机预后
Keywords:
carbon monoxide poisoning hyperbaric oxygen therapy intervention timing prognosis
分类号:
R181.32; R459.6; R595.1
文献标志码:
A
摘要:

目的探讨中重度急性一氧化碳中毒患者首次进行高压氧治疗的时机及其对神经功能恢复和生活质量的影响。方法回顾性分析2015年1月至2018年6月本院高压氧治疗中心收治的急性一氧化碳中毒患者,对满足中毒在24 h以内、未在其他医院行高压氧治疗、中毒程度为中重度者按首次治疗时间分3组:超早期组(中毒后6 h内)、早期组(中毒后6~12 h)和普通组(中毒后>12~24 h)。比较3组治疗后的症状恢复程度(完全恢复、部分恢复、未恢复)、格拉斯哥昏迷指数(GCS)、简易智力状态量表(MMSE)、Barthel指数(BI)、迟发性脑病发生率的差异。结果共纳入136例患者,其中超早期组39例、早期组51例、普通组46例。各组在年龄、性别分布及总治疗次数上差异无统计学意义。高压氧治疗结束时,超早期组、早期组及普通组中患者症状完全恢复的比例分别为43.5%、31.4%、17.4%;GCS评分改善值分别为4.85、3.87、3.01;MMSE评分改善值分别为19.01、14.05、12.34;BI指数改善值分别为75.48、68.24、54.58。治疗后1年随访显示,超早期组发生迟发性脑病2例(5.1%),早期组发生7例(13.7%),普通组发生14例(30.4%)。所有指标超早期组显著优于普通组,在症状完全恢复的比例、MMSE评分、迟发脑病发生率3项指标上也显著优于早期组,差异均有统计学意义(P<0.05)。结论在中毒后6 h内实施高压氧治疗可使中重度急性一氧化碳中毒患者的预后更佳。

Abstract:

ObjectiveTo investigate the the timing of the first time of hyperbaric oxygen therapy and its effect on the recovery of neurological function and quality of life in patients with acute moderate to severe carbon monoxide poisoning. MethodsA retrospective analysis was carried out in the patients with acute carbon monoxide poisoning admitted to our hyperbaric oxygen treatment center from January 2015 to June 2018. The patients who met the criteria of poisoning within 24 h, did not receive hyperbaric oxygen treatment in other hospitals, and had moderate or severe poisoning were divided into 3 groups according to the first treatment time, that is, ultra-early group (shorter than 6 h after poisoning), early group (within 6~12 h), and ordinary group (in 12~24 h after poisoning). The degree of recovery (complete recovery, partial recovery, no recovery), Glasgow coma index (GCS), simple mental state scale (MMSE), Barthel index (BI) and incidence of delayed encephalopathy after treatment was compared among the 3 groups. ResultsA total of 136 patients were eligible for admission, including 39 in the ultra-early group, 51 in the early group and 46 in the ordinary group. There were no significant differences in age, sex distribution and total treatment times among the groups. At the end of treatment, the proportions of patients with complete recovery were 43.5%, 31.4%, and 17.4%, respectively in the ultra-early group, early group and ordinary group. The improvement of GCS score was 4.85, 3.87 and 3.01, respectively, that of MMSE score was 19.01, 14.05, and 12.34, respectively, and that of BI was 75.48, 68.24 and 54.58, respectively, in the 3 groups. In 1 year after the treatment, delayed encephalopathy was observed in 2 cases (5.1%) in the ultra-early group, 7 cases (13.7%) in the early group, and 14 cases (30.4%) in the ordinary group. The ultra-early group obtained all better indicators than the ordinary group, and better percentage of complete recovery of symptoms, MMSE score and lower incidence of delayed encephalopathy when compared with the early group (all P<0.05). ConclusionImplementation of hyperbaric oxygen therapy within 6 h after poisoning can result in a better prognosis for patients with moderate to severe acute carbon monoxide poisoning.

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更新日期/Last Update: 2020-03-06