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目的分析和探讨高压氧治疗老年一氧化碳中毒迟发性脑病(Delayed Encephalopathy Af-ter Carbon Monoxide Poisoning,DEACMP)的临床效果。方法选取我院2000～2010年收治的被确诊为一氧化碳中毒迟发性脑病(DEACMP)老年患者共28例,治疗方法为常规治疗和高压氧治疗(HyperbaricOxygen,HBO)相结合的方法。结果治疗28例患者当中,痊愈18例(64.3%,18/28),显效4例(22.2%,4/28),有效3例(10.7%,3/28),无效2例(7.1%,2/28),死亡1例(3.6%,1/28);高压氧治疗越早临床效果越好,且15d内开始高压氧治疗的疗效明显优于15d后开始治疗的(P<0.01);治疗次数越多,效果越显著(P<0.01);未切开气管者进行治疗的效果显著优于切开气管者的效果(P<0.01);患者神经系统受损程度越高,治愈率越低(P<0.01)。结论对于急性一氧化碳中毒者,尤其是老年患者,迟发脑病的发病率高,应该给予早期、及时、足疗程的高压氧(HBO)治疗,这对于提高临床效果、改善生活质量都有非常大的益处。
Objective To analyze and explore the clinical effect of hyperbaric oxygen therapy on Delayed Encephalopathy Af-ter Carbon Monoxide Poisoning (DEACMP). Methods A total of 28 senile patients with DEACMP who were admitted to our hospital from 2000 to 2010 were enrolled in this study. The treatment method was a combination of conventional therapy and Hyperbaric Oxygen (HBO). Results Among 28 patients, 18 cases were cured (64.3%, 18/28), 4 cases (22.2%, 4/28) were cured, 3 cases (10.7%, 3/28) were effective and 2 cases were ineffective (7.1% (3.6%, 1/28). The earlier the hyperbaric oxygen therapy was, the better the clinical effect was. The effect of starting hyperbaric oxygen therapy within 15 days was significantly better than that of 15 days (P <0.01). The more the treatment times, the more obvious the effect was (P <0.01). The effect of uncut trachea was better than that of tracheotomy (P <0.01). The higher the degree of nervous system injury, the more the cure rate Low (P <0.01). Conclusions For patients with acute carbon monoxide poisoning, especially elderly patients, the incidence of delayed encephalopathy is high, and should be given early, timely and full course of hyperbaric oxygen therapy (HBO), which has great effect on improving clinical effect and improving quality of life benefit.