一氧化碳中毒迟发性脑病高压氧治疗剂量与疗效

摘要

Objective To evaluate the efficacy of two doses of hyperbaric oxygen therapy (HBOT) on delayed encephalopathy after carbon monoxide poisoning (DEACMP). Methods 68 patients with DEACMP were divided into two groups, the 30 sessions of HBOT group (30-HBOT group) and the 60 sessions of HBOT group (60-HBOT group), who were given HBOT 30 and 60 times respectively. All patients were assessed with Mini-Mental State Examination (MMSE) and fluid attenuated inversion recovery (Flair) magnetic resonance imaging of brain immediately before, 35 d and 70 d after HBOT. Results The MMSE score was significantly higher in 60-HBOT group than in 30-HBOT group 70 d after HBOT (P<0.01). All of patients showed diffuse and confluent hyper-intensity over the bilateral periventricular white matter and centrum semiovale on conventional T2WI and Flair, which improved. Conclusion HBOT is effective on DEACMP, especially with 60 times.%目的 探讨高压氧治疗(HBOT)一氧化碳中毒迟发性脑病(DEACMP)的不同剂量与疗效的关系.方法DEACMP患者68例分成HBOT 30次组和HBOT 60次组,分别于治疗前,治疗后35 d、70 d进行简易智能精神状态检查量表(MMSE)评分,同时进行脑部MRI+Flair影像学检查.结果治疗后70 d时,HBOT 60次组患者MMSE评分基本恢复正常,显著高于HBOT 30次组.脑核磁T2和Flair序列影像显示大脑半卵圆区和脑室周围区呈弥漫性高信号改变,HBOT后有所改善.结论HBOT对DEACMP具有明显疗效,在患者发病早期开始连续60次治疗效果最为显著.