高压氧在急性一氧化碳中毒患者急救中的临床效果
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摘要
目的:研究高压氧在急性一氧化碳中毒患者急救中的临床效果。方法:选取2015年1月-2018年5月因一氧化碳中毒来院诊治的52例患者作为研究资料,在纠正患者呼吸心率、抗炎药等常规治疗的基础上给予高压氧治疗,对比分析治疗前后的心率(HR)、肝肾功能、治疗效果和并发症发生率。结果:治疗前后HR、肝肾功能(ALT、Scr、白蛋白、胆红素)比较,差异均有统计学意义(P<0.05)。治疗后,显效46例(88.5%),有效5例(9.6%),无效1例(1.9%),总有效率为98.1%。治疗后,泌尿感染2例(3.8%),心肌损伤1例(1.9%),肺部感染1例(1.9%),迟发性脑病2例(3.8%),并发症总发生率为11.5%。结论:急性一氧化碳中毒患者应迅速进行高压氧治疗,高压氧治疗不仅可以快速恢复一氧化碳中毒对患者机体造成的损伤,还可以大幅度降低一氧化碳中毒后对患者产生的并发症,应将此治疗方法作为治疗急性一氧化碳中毒的金标准。
Objective:To study the clinical effect of hyperbaric oxygen in emergency treatment of patients with acute carbon monoxide poisoning.Method:A total of 52 patients hospitalized for carbon monoxide poisoning from January 2015 to May 2018 were selected.Hyperbaric oxygen therapy was given on the basis of routine treatment such as correction of the patient's respiratory heart rate and anti-inflammatory drugs.The heartrate(HR),liver and kidney function,treatment efficacy,and complication ratebefore and after treatment were compared and analyzed.Result:There were significant differences between before and after treatment in HR(P<0.05).There were significant differences in ALT,Scr,albumin and bilirubin before and after treatment(P<0.05).After treatment,among 52 patients with carbon monoxide poisoning,46 cases(88.5%)were markedly effective, 5 cases(9.6%)were effective,1 case(1.9%)was ineffective,the total effective rate was 98.1%.After treatment,2 cases(3.8%)had urinary infection,1 case(1.9%) had myocardial injury,1 case(1.9%)had pulmonary infection and 2 cases(3.8%)had delayed encephalopathy,the total incidence of complications was11.5%.Conclusion:Patients with acute carbon monoxide poisoning should be treated with hyperbaric oxygen therapy.Hyperbaric oxygen therapy can not only quickly recover the injury caused by carbon monoxide poisoning,but also significantly reduce the complications of carbon monoxide poisoning.This treatment should be regarded as the gold standard for the treatment of acute carbon monoxide poisoning.
Objective:To study the clinical effect of hyperbaric oxygen in emergency treatment of patients with acute carbon monoxide poisoning.Method:A total of 52 patients hospitalized for carbon monoxide poisoning from January 2015 to May 2018 were selected.Hyperbaric oxygen therapy was given on the basis of routine treatment such as correction of the patient's respiratory heart rate and anti-inflammatory drugs.The heartrate(HR),liver and kidney function,treatment efficacy,and complication ratebefore and after treatment were compared and analyzed.Result:There were significant differences between before and after treatment in HR(P<0.05).There were significant differences in ALT,Scr,albumin and bilirubin before and after treatment(P<0.05).After treatment,among 52 patients with carbon monoxide poisoning,46 cases(88.5%)were markedly effective, 5 cases(9.6%)were effective,1 case(1.9%)was ineffective,the total effective rate was 98.1%.After treatment,2 cases(3.8%)had urinary infection,1 case(1.9%) had myocardial injury,1 case(1.9%)had pulmonary infection and 2 cases(3.8%)had delayed encephalopathy,the total incidence of complications was11.5%.Conclusion:Patients with acute carbon monoxide poisoning should be treated with hyperbaric oxygen therapy.Hyperbaric oxygen therapy can not only quickly recover the injury caused by carbon monoxide poisoning,but also significantly reduce the complications of carbon monoxide poisoning.This treatment should be regarded as the gold standard for the treatment of acute carbon monoxide poisoning.
引文
[1]李聪,许铁.醒脑静联合高压氧对急性一氧化碳中毒患者治疗效果及对肝、肾功能影响的分析[J].胃肠病学和肝病学杂志,2015,24(6):731-734.
[2]崔苗.试析醒脑静联合高压氧对急性一氧化碳中毒患者治疗效果及其对肝、肾功能影响[J].饮食保健,2016,3(1):16.
[3]郑瑞娟.急性一氧化碳后迟发型脑病危险因素及基因多态性分析[J].中西医结合心脑血管病杂志,2016,14(10):1183-1184.
[4]赵彩梅.急性一氧化碳中毒高压氧治疗中整体护理干预的应用效果[J/OL].实用临床护理学电子杂志,2017,2(24):66,70.
[5]周九军,翟昱光.早期高压氧治疗对急性一氧化碳中毒心肌损伤的影响[J].河南医学研究,2017,26(15):2725-2726.
[6]田军苗.纳美芬联合醒脑静对急性一氧化碳中毒高压氧治疗患者生存质量的影响[J].中国卫生工程学,2017,16(2):180-182.
[7]游伟星,江倩华,张杰雄.高压氧联合纳洛酮治疗急性一氧化碳中毒的50例临床分析[J].中国现代医生,2016,54(21):104-106.
[8]李敬,孔繁托,李颖,等.一氧化碳迟发性脑病患者应用神经节苷酯和纳美芬治疗前后MDA、SOD的变化[J].中国急救复苏与灾害医学杂志,2016,11(6):591-593.
[9]吕艳英,荣阳,荣根满.高压氧治疗急性一氧化碳中毒后迟发性脑病的疗效分析与临床研究[J].中国医药指南,2015,13(2):154-155.
[10] Huang C C,Ho C H,Chen Y C,et al.Hyperbaric Oxygen Therapy Is Associated With Lower Short-and Long-Term Mortality in Patients With Carbon Monoxide Poisoning[J].Chest,2017,152(5):943-953.
[11]李香枝.高压氧对中重度急性一氧化碳中毒的疗效及对其迟发性脑病的预防[J].职业与健康,2012,28(16):2047-2048.
[12]唐学军.纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床研究[J].中国医药导报,2012,9(13):46-47,50.
[13] Kuniavsky M,Bechor Y,Leitman M,et al.Carbon monoxide poisoning in a young,healthy patient:A case study of heart failure recovery after Hyperbaric Oxygenation Treatment[J].Intensive Crit Care Nurs,2018,8(47):85-88.
[14]郭玉平.对接受高压氧治疗的急性一氧化碳中毒患者实施整体护理干预的效果分析[J].当代医药论丛,2015,13(10):102-103.
[15]杜军.急诊高压氧对急性一氧化碳中毒治疗的临床疗效观察[J/OL].临床医药文献电子杂志,2018,5(3):63,65.
[16]林素莲,沈炳荣,高惠珍.高压氧治疗急性一氧化碳中毒257例效果分析[J].中国卫生标准管理,2015,6(28):42-44.
[17] Yoshiike T,Nishida M,Yagishita K,et al.Altered Sleep Spindles in Delayed Encephalopathy after Acute Carbon Monoxide Poisoning[J].J Clin Sleep Med,2016,12(6):913-915.
[18]张涛.激素联合高压氧治疗急性一氧化碳中毒迟发性脑病的疗效研究[J].中国保健营养,2018,28(15):196.
[19] Hou X,Ma L,Wu L,et al.Diffusion tensor imaging for predicting the clinical outcome of delayed encephalopathy of acute carbon monoxide poisoning[J].Eur Neurol,2013,69(5):275-280.
[20]胡守芹.依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床观察[J].临床急诊杂志,2016,17(4):289-291,295.
[21] Mori K,Beppu T,Fujisawa Y,et al.Effect of free radical scavenger,edaravone,for patients with carbon monoxide poisoning[J].Clin Neurol Neurosurg,2015,12(139):56-61.
[22]赵云芳,付印,崔新霞,等.神经节苷脂联合高压氧治疗急性一氧化碳中毒疗效观察[J].临床合理用药杂志,2016,9(8):83-85.
[23]谭震.高压氧治疗急性一氧化碳中毒的临床疗效观察[J].临床合理用药杂志,2016,9(2):105-106.
[24]朱红伟,朱红霞.高压氧不同治疗方案在急性一氧化碳中毒中的临床研究[J].医药前沿,2015,5(6):128-130.
[25]林素莲,沈炳荣,高惠珍.高压氧治疗急性一氧化碳中毒257例效果分析[J].中国卫生标准管理,2015,7(28):42-44.
[2]崔苗.试析醒脑静联合高压氧对急性一氧化碳中毒患者治疗效果及其对肝、肾功能影响[J].饮食保健,2016,3(1):16.
[3]郑瑞娟.急性一氧化碳后迟发型脑病危险因素及基因多态性分析[J].中西医结合心脑血管病杂志,2016,14(10):1183-1184.
[4]赵彩梅.急性一氧化碳中毒高压氧治疗中整体护理干预的应用效果[J/OL].实用临床护理学电子杂志,2017,2(24):66,70.
[5]周九军,翟昱光.早期高压氧治疗对急性一氧化碳中毒心肌损伤的影响[J].河南医学研究,2017,26(15):2725-2726.
[6]田军苗.纳美芬联合醒脑静对急性一氧化碳中毒高压氧治疗患者生存质量的影响[J].中国卫生工程学,2017,16(2):180-182.
[7]游伟星,江倩华,张杰雄.高压氧联合纳洛酮治疗急性一氧化碳中毒的50例临床分析[J].中国现代医生,2016,54(21):104-106.
[8]李敬,孔繁托,李颖,等.一氧化碳迟发性脑病患者应用神经节苷酯和纳美芬治疗前后MDA、SOD的变化[J].中国急救复苏与灾害医学杂志,2016,11(6):591-593.
[9]吕艳英,荣阳,荣根满.高压氧治疗急性一氧化碳中毒后迟发性脑病的疗效分析与临床研究[J].中国医药指南,2015,13(2):154-155.
[10] Huang C C,Ho C H,Chen Y C,et al.Hyperbaric Oxygen Therapy Is Associated With Lower Short-and Long-Term Mortality in Patients With Carbon Monoxide Poisoning[J].Chest,2017,152(5):943-953.
[11]李香枝.高压氧对中重度急性一氧化碳中毒的疗效及对其迟发性脑病的预防[J].职业与健康,2012,28(16):2047-2048.
[12]唐学军.纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床研究[J].中国医药导报,2012,9(13):46-47,50.
[13] Kuniavsky M,Bechor Y,Leitman M,et al.Carbon monoxide poisoning in a young,healthy patient:A case study of heart failure recovery after Hyperbaric Oxygenation Treatment[J].Intensive Crit Care Nurs,2018,8(47):85-88.
[14]郭玉平.对接受高压氧治疗的急性一氧化碳中毒患者实施整体护理干预的效果分析[J].当代医药论丛,2015,13(10):102-103.
[15]杜军.急诊高压氧对急性一氧化碳中毒治疗的临床疗效观察[J/OL].临床医药文献电子杂志,2018,5(3):63,65.
[16]林素莲,沈炳荣,高惠珍.高压氧治疗急性一氧化碳中毒257例效果分析[J].中国卫生标准管理,2015,6(28):42-44.
[17] Yoshiike T,Nishida M,Yagishita K,et al.Altered Sleep Spindles in Delayed Encephalopathy after Acute Carbon Monoxide Poisoning[J].J Clin Sleep Med,2016,12(6):913-915.
[18]张涛.激素联合高压氧治疗急性一氧化碳中毒迟发性脑病的疗效研究[J].中国保健营养,2018,28(15):196.
[19] Hou X,Ma L,Wu L,et al.Diffusion tensor imaging for predicting the clinical outcome of delayed encephalopathy of acute carbon monoxide poisoning[J].Eur Neurol,2013,69(5):275-280.
[20]胡守芹.依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床观察[J].临床急诊杂志,2016,17(4):289-291,295.
[21] Mori K,Beppu T,Fujisawa Y,et al.Effect of free radical scavenger,edaravone,for patients with carbon monoxide poisoning[J].Clin Neurol Neurosurg,2015,12(139):56-61.
[22]赵云芳,付印,崔新霞,等.神经节苷脂联合高压氧治疗急性一氧化碳中毒疗效观察[J].临床合理用药杂志,2016,9(8):83-85.
[23]谭震.高压氧治疗急性一氧化碳中毒的临床疗效观察[J].临床合理用药杂志,2016,9(2):105-106.
[24]朱红伟,朱红霞.高压氧不同治疗方案在急性一氧化碳中毒中的临床研究[J].医药前沿,2015,5(6):128-130.
[25]林素莲,沈炳荣,高惠珍.高压氧治疗急性一氧化碳中毒257例效果分析[J].中国卫生标准管理,2015,7(28):42-44.