| Objective:Carbon monoxide(CO) is one of the most common suffocating gas, and the acute carbon monoxide poisoning(ACMP) is on the top of the death list of all kinds of acute intoxication around the world. One of the most serious complications of acute carbon monoxide poisoning is sequela of acute carbon monoxide poisoning, which include delayed encephalopathy after acute carbon monoxide poisoning(DEACMP) and nerve injury after acute carbon monoxide poisoning.It is difficult and require a long time to treat thus brings heavy burden to family and the society. This research analyzes clinical feature and therapeutic process of 120 ACMP patients that are treated in the emergency department of General Hospital of Jincheng coal. To study the clinical effect of Nalmefene and Xingnaojing combined with hyperbaric oxygen in treatment of acute carbon monoxide poisoning and investigate the long-term curative effect of incidence of sequela, aim to provide certain reference significance for clinical treatment.Methods:A retrospective study was conducted to analyze the clinical data of 120 carbon monoxide poisoning patients in the emergency department of General Hospital of Jincheng coal group during November 2010 to March 2014. There were 60 patients using combined treatment, while 60 patients using conventional treatments. Conventional treatments: high concentration and flow of oxygen,nutritional support and hyperbaric oxygen chamber in order to maintain water-electrolyte balance and to prevent encephaledema. Combined treatment: on the basis of contarstgroup, hyperbaric intravenous drip of Nalmefene and Xingnaojing. Comparing clinical efficacy, the average recovery time, GCS score before and after treatment and follow-up the occurrence of delayed encephalopathy and neurological injury in two groups. By using χ2 test, Logistic regression model to explore risk factors of sequela of acute carbon monoxide poisoning.Results:(1) The effective rate of the combined treatment group(95%) was significantly higher than the contrast group(78.33%), and the difference was statistically significant(P<0.05).(2) The average recovery time of the combined treatment groupwas(4.27±1.06)hand the contrast group was(7.14±1.68) h. The average recovery time of the combined treatment group was significantly faster than that of the contrast group, and the difference was statistically significant(P<0.05).(3) The GCS score of two groups were significantly increased after treatment( P<0.05) and the GCS score after treatment of combined treatment group were significantly higher than those in the contrast group(P<0.05). The difference of GCS score of combined treatment group is higher than contrast group, and there were significant differences(P<0.05).(4) After follow-up half year later, the incidence of delayed encephalopathy after acute carbon monoxide poisoning in the combined treatment group(1.67%, 1/60) was lower than that in the contrast group(15%, 9/60), and the difference was statistically significant(P<0.05).(5) The incidence of neurological injury after acute carbon monoxide poisoning in the combined treatment group(5%, 3/60) was lower than that of the contrast group(20%,12/60), and the difference was statistically significant(P<0.05).(6) Chi-square test showed that differences were statistically significant(P<0.05) in age, treatment, coma time and the GSC before treatment between combined treatmentgroup and contrast group.(7) Unconditional regression model showed that the risk factor of sequela of acute carbon monoxide poisoning include: the treatment(OR=0.026, 95%CI: 0.002~0.366), the GSC before treatment(OR=0.015, 95%CI: 0.001~0.155).Conclusions:Nalmefene and Xingnaojing combined with hyperbaricoxygen in the treatment of acute carbon monoxide poisoning clinical curative effect is excellent.It accelerate patient recovery time, lighten the symptoms of patients with coma and reduce the risk of delayed encephalopathy and nervous system damage, which has an important research significance. |
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