CAJ | 학술논문

目的探讨不同高压氧(hyperbaric oxygen,HBO)治疗方案对急性一氧化碳(carbon monoxide,CO)中毒受损心肌的影响.方法对2006年10月至2010年3月收治的155例重症CO中毒患者进行HBO常规治疗(常规组,75例)和HBO改进治疗(改进组,80例).(1)常规组治疗方案:治疗压力0.25 MPa,加压20 min,稳压后吸氧2次,每次30 min,中间间歇10 min,减压20 min出舱.每日1次,12次为1个疗程,治疗9-68次.(2)改进组方案:前5 d采用HBO常规治疗,以后采用减小治疗压力、缩短吸氧时间、增加吸氧间隔、间歇给氧的治疗方案,治疗压力0.20 MPa,稳压吸氧4次,每次10min,中间间歇5 min,减压20 min出舱.连续治疗3 d后间隔1 d,10 d为1个疗程.2组患者使用相同的药物治疗方案.统计分析常规组和改进组ST-T变化及血清心肌酶变化.结果改进组与常规组相比ST-T恢复率(56%,28%)明显升高(P＜0.05),HBO治疗第3天和第6天ST-T加重率(第3天21%、25%.第6天16%、27%)明显降低(P＜0.01);2组血清心肌酶恢复率和加重率比较差异有统计学意义(P＜0.05.P＜0.01).结论 HBO改进方案对CO中毒患者受损心肌疗效较好.
목적 탐토불동고압양(hyperbaric oxygen,HBO)치료방안대급성일양화탄(carbon monoxide,CO)중독수손심기적영향.방법 대2006년10월지2010년3월수치적155례중증CO중독환자진행HBO상규치료(상규조,75례)화HBO개진치료(개진조,80례).(1)상규조치료방안:치료압력0.25 MPa,가압20 min,은압후흡양2차,매차30 min,중간간헐10 min,감압20 min출창.매일1차,12차위1개료정,치료9-68차.(2)개진조방안:전5 d채용HBO상규치료,이후채용감소치료압력、축단흡양시간、증가흡양간격、간헐급양적치료방안,치료압력0.20 MPa,은압흡양4차,매차10min,중간간헐5 min,감압20 min출창.련속치료3 d후간격1 d,10 d위1개료정.2조환자사용상동적약물치료방안.통계분석상규조화개진조ST-T변화급혈청심기매변화.결과 개진조여상규조상비ST-T회복솔(56%,28%)명현승고(P＜0.05),HBO치료제3천화제6천ST-T가중솔(제3천21%、25%.제6천16%、27%)명현강저(P＜0.01);2조혈청심기매회복솔화가중솔비교차이유통계학의의(P＜0.05.P＜0.01).결론 HBO개진방안대CO중독환자수손심기료효교호.
Objective To investigate the effects of different hyperbaric oxygen ( HBO) treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide ( CO) poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group (the routine group,75 cases) and the improved HBO treatment group (the improved group,80 cases). The treatment profile of the routine HBO treatment group: the patients were compressed for 20 min to the treatment pressure of 0.25 Mpa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 min plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group: the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure (0.20 Mpa) , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 min. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased (56% ,28% ) obviously, when compared with that of the routine HBO treatment group(P ＜ 0. 05). ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days (21% and 25% on the 3rd day, 16% and 27% on the 6th day) respectively (P＜0.01). Statistical differences could be seen in the myocardial recovery rate and worse rate, when a comparison was made between them (P＜0. 05, P＜0. 01). Conclusions The improved HBO treatment profile showed better therapeutic effect on damaged myocardium induced by CO poisoning. This treatment profile should be used instead of other treatment profiles.