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目的研究及观察一氧化碳中毒并发肺部感染患者甲襞微循环及脑血流状态的变化,为其制定治疗干预措施提供依据。方法选取2009年10月-2013年12月在医院进行治疗的235例一氧化碳中毒患者为研究对象,将235例患者根据是否发生肺部感染分为一氧化碳中毒组(A组)160例和一氧化碳中毒肺部感染组(B组)75例,将两组患者的甲襞微循环及脑血流指标进行检测与比较,对B组中不同感染程度者的检测水平进行统计与比较。结果 B组的管襻积分、襻周状态积分及管襻畸形率、白微栓率分别为(1.29±0.15)分、(1.95±0.24)分及(35.46±3.27)%、(1.98±0.25)%,均高于A组的(0.75±0.10)分、(1.02±0.14)分及(19.33±2.15)%、(1.31±0.14)%,差异有统计学意义(P<0.05);B组的大脑中动脉Vs及Vd指标,分别为(0.75±0.05)m/s及(0.27±0.04)m/s,均低于A组的(1.08±0.09)m/s及(0.56±0.06)m/s,而PI及RI指标则高于A组,差异均有统计学意义(P<0.05)。结论一氧化碳中毒并发肺部感染患者甲襞微循环及脑血流呈现异常的状态,且微循环受感染严重程度的影响较大,因此应重视对该类患者进行甲襞微循环及脑血流的改善。
Objective To study and observe the changes of formazan microcirculation and cerebral blood flow in patients with carbon monoxide poisoning complicated by pulmonary infection and provide the basis for making therapeutic interventions. Methods Totally 235 patients with carbon monoxide poisoning who were treated in the hospital from October 2009 to December 2013 were enrolled. According to whether there were pulmonary infections, 235 patients were divided into 160 cases of carbon monoxide poisoning (group A) and carbon monoxide poisoning lung (Group B) 75 cases, the two groups of patients with nailfold microcirculation and cerebral blood flow index were detected and compared in the B group of different levels of infection were detected and compared. Results The scores of tubal score, periocular state, tubal deformity and white microthrombus in group B were (1.29 ± 0.15), (1.95 ± 0.24) and (35.46 ± 3.27)%, (1.98 ± 0.25)%, Were significantly higher than those in group A (0.75 ± 0.10), (1.02 ± 0.14) and (19.33 ± 2.15)%, (1.31 ± 0.14)% respectively, with significant difference (P <0.05) The Vs and Vd of arteries were (0.75 ± 0.05) m / s and (0.27 ± 0.04) m / s respectively, which were lower than those of group A (1.08 ± 0.09) m / s and (0.56 ± 0.06) m / The indexes of PI and RI were higher than that of group A, the differences were statistically significant (P <0.05). Conclusions Patients with carbon monoxide poisoning complicated by pulmonary infection have abnormal microcirculation and cerebral blood flow, and the microcirculation is greatly affected by the severity of infection. Therefore, attention should be paid to the treatment of microcirculation and cerebral blood flow in patients with carbon monoxide poisoning improve.