高压氧治疗急性脑病一氧化碳中毒继发性心肌损伤的疗效探讨

Z. Yanping, Z. Pan, Lv Changchun
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引用次数: 0

摘要

目的:探讨一氧化碳中毒急性脑病的心肌损害及高压氧治疗。方法:自2015年3月- 2020年3月收治急性一氧化碳中毒脑病患者125例,急诊入院GCS评分7-8分及以下,并对颅内压、心肌损伤标志物酶(CK - MB、CK、LDH、MYO、BNP)及肌钙蛋白(cTnl)、动脉COHb定量及心电图(EKG)动态检查,行CT、MRI检查,可同时采用气压舱高压氧治疗。每位患者选择2.5-3个疗程治疗(每10次为一个疗程),氧纯度99.5-100%(液氧气化),供氧时间60分钟或80分钟,间歇10分钟。结果:125例患者COHb越高,昏迷越深,颅内压升高,颅内高压,出现弥漫性脑水肿、对称性球蛋白坏死等形态学改变。心肌损伤酶和肌钙蛋白标志物明显升高,心电图异常基本一致。HBO治疗取得显著疗效,迟发性脑病发生率明显降低,无死亡病例发生。结论:一氧化碳中毒致急性脑病颅内压升高可显著增加心肌损害、心内膜下心肌梗死、左心衰及各种心律失常的发生率。HBO是一种治疗病因的方法,应该优先考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Explore of Hyperbaric Oxygen Therapy on the Patients with Acute Encephalopathy Scondery Myocardial Damage Following Carbon Monoxide Poising
Objective: To investigate the myocardial damage and hyperbaric oxygen treatment of acute encephalopathy in CO poisoning. Methods: Since March 2015 - March 2020 admitted to 125 patients with acute CO poisoning encephalopathy, emergency admission GCS score 7-8 points or less, and the intracranial pressure, myocardial damage markers enzymes (CK - MB, CK, LDH, MYO, BNP) and troponin (cTnl), arterial COHb quantitative and electrocardiogram (EKG) dynamic inspection, row CT, MRI examination can at the same time, using air pressure cabin HBO treatment, Each patient choose 2.5-3 period of treatment (Every10 times is a course of treatment), 99.5-100% oxygen purity (liquid oxygen gasification), oxygen supply time 60 minutes or 80 minutes, interlude 10 minutes. Results: The higher the COHb, the deeper the coma, the increased intracranial pressure, the intracranial hypertension, and the morphological changes such as diffuse cerebral edema and symmetrical globulin necrosis were observed in 125 patients. However, the myocardial damaging enzymes and troponin markers were significantly increased and the EKG abnormalities were basically consistent. HBO treatment achieved remarkable curative effect, the incidence of delayed encephalopathy was significantly reduced, and no death occurred. Conclusion: Increased intracranial pressure induced by acute encephalopathy induced by CO poisoning can significantly increase the incidence of myocardial damage, subendocardial myocardial infarction, left heart failure and various arrhythmias. HBO is a treatment for etiology and should be preferred.
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