摘要
目的观察急性一氧化碳中毒患者使用不同剂量纳洛酮联合高压氧治疗的预后情况。方法在本院2020年2月—2022年2月收治的急性一氧化碳中毒患者中选取90例,按照随机数字表法分为两组,研究组(45例)给予大剂量纳洛酮[0.04 mg/(kg·min),总剂量不超过4.0 mg]联合高压氧治疗,对照组(45例)给予常规剂量纳洛酮[0.01 mg/(kg·min)]联合高压氧治疗,比较两组疗效、临床指标[催醒时间,住院时间,简易智力状态检查量表(MMSE)]、血清酶指标[心肌激酶(CK),乳酸脱氢酶(LDH),丙氨酸转氨酶(ALT),天氡氨酸转氨酶(AST)]、不良反应、预后(迟发性脑病,死亡)。结果研究组总有效率高于对照组(P<0.05);研究组催醒时间、住院时间均短于对照组(P<0.05),治疗后两组MMSE评分均升高(P<0.05),且研究组MMSE评分高于对照组(P<0.05);治疗后两组CK、LDH、ALT、AST水平均降低(P<0.05),且研究组CK、LDH、ALT、AST水平低于对照组(P<0.05);两组不良反应比较无明显差异(P>0.05);两组均随访6个月,结果显示研究组死亡1例(2.22%)、并发迟发性脑病2例(4.44%),对照组死亡3例(6.67%),并发迟发性脑病7例(15.56%),两组比较有统计学差异(P<0.05)。结论在急性一氧化碳中毒患者中应用大剂量纳洛酮联合高压氧治疗疗效显著,能促进病情好转,且预后及安全性均较好。
Objective To observe the prognosis of patients with acute carbon monoxide poisoning treated with different doses of naloxone combined with hyperbaric oxygen.Methods 90 patients with acute carbon monoxide poisoning admitted to our hospital from February 2020 to February 2022 were randomly divided into two groups using a random number table method.The study group(45 cases)received high-dose naloxone[0.04 mg/(kg•min),total dose not exceeding 4.0 mg]combined with hyperbaric oxygen treatment,while the control group(45 cases)received conventional dose naloxone[0.01 mg/(kg•min)]combined with hyperbaric oxygen treatment.The efficacy,clinical indicators[awakening time,hospital stay,simplified mental state examination scale(MMSE)],serum enzyme indicators[myocardial kinase(CK),lactate dehydrogenase(LDH),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],adverse reactions,and prognosis(delayed encephalopathy,death)were compared between the two groups.Results The total effective rate of the research group was higher than that of the control group(P<0.05);The awakening time and hospitalization time in the study group were shorter than those in the control group(P<0.05).After treatment,MMSE scores in both groups were increased(P<0.05),and MMSE scores in the study group were higher than those in the control group(P<0.05).After treatment,the levels of CK,LDH,ALT and AST in both groups were decreased(P<0.05),and the levels of CK,LDH,ALT and AST in study group were lower than those in control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05);Both groups were followed up for 6 months.The results showed that there were 1(2.22%)deaths in the study group,2(4.44%)cases of delayed encephalopathy,3(6.67%)deaths in the control group,and 7(15.56%)cases of delayed encephalopathy.There was a statistical difference between the two groups(P<0.05).Conclusion The application of high-dose naloxone combined with hyperbaric oxygen therapy in patients with acute carbon monoxide poiso
作者
朱浩
彭国兵
吴亚达
ZHU Hao;PENG Guobing;WU Yada(Emergency Department,Suzhou Jiulong Hospital,Shanghai Jiaotong University School of Medicine,Suzhou Jiangsu 215208,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第5期620-623,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
急性一氧化碳中毒
纳洛酮
高压氧
神经功能
Acute carbon monoxide poisoning
Naloxone
Hyperbaric oxygen
Neural function
