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目的观察急性中、重度硫化氢中毒患者给予高压氧治疗的时机对患者血清心肌肌钙蛋白Ⅰ(CTnⅠ)的影响及其预后的关系。方法根据患者发病到首次进入高压氧的时间将患者归为三组。A组23例均在发病2h内开始接受高压氧治疗,B组15例为发病后2~6h接受高压氧治疗,C组8例发病到首次进入高压氧治疗为6h以上。回顾性观察三组患者入院即刻、第2天、第5天及第10天血清CTnⅠ的定量测定值进行比较,对比三组患者血清TNⅠ的变化规律及预后。结果三组患者治疗前的CTnⅠ测定值差异无统计学意义(P>0.05);第2天血清CTnⅠ均达到高峰,但峰值差异有统计学意义(A组与B组比较P<0.05;C组与A组比P<0.01),第5天及第10天各组CTnⅠ差异仍有统计学意义。A组患者治愈17例,好转4例,总有效率21/23;B组患者治愈9例,好转3例,有效率12/15;C组患者治愈1例,好转3例,有效率4/8,各组有效率差异有统计学意义(P<0.01)。结论中、重度硫化氢中毒患者进入高压氧治疗越早,血清CTnⅠ值恢复越快,心肌损害越轻,预后越好。
Objective To investigate the effect of hyperbaric oxygen (HBO) therapy on the serum level of cardiac troponin Ⅰ (CTn Ⅰ) and its prognosis in patients with acute moderate and severe hydrogen sulfide poisoning. Methods Patients were divided into three groups according to the time from the onset of the disease to the first admission of hyperbaric oxygen. All 23 patients in group A started hyperbaric oxygenation within 2 hours after onset, 15 patients in group B received hyperbaric oxygen therapy 2 to 6 hours after onset, and 8 patients in group C went into hyperbaric oxygen therapy for the first time for more than 6 hours. Retrospective observation of three groups of patients immediately after admission, the first 2 days, 5 days and 10 days serum CTn Ⅰ quantitative determination of values compared to compare the three groups of patients TNI changes and prognosis. Results There was no significant difference between the three groups before treatment (P> 0.05). On the second day, serum CTnI peaked but the difference was statistically significant (P <0.05 for group A and group C; Compared with group A, P <0.01), there was still significant difference in CTnI between the 5th and 10th day in each group. A group of patients cured 17 cases, improved in 4 cases, the total effective rate 21/23; B group of patients were cured in 9 cases, improved in 3 cases, the effective rate of 12/15; C group of patients were cured in 1 case, improved in 3 cases, the effective rate of 4 / 8, the effective rate of each group was statistically significant (P <0.01). Conclusions The earlier the patients with severe hydrogen sulfide poisoning get hyperbaric oxygen therapy, the faster the CTnI value of serum is recovered, the less myocardial damage is and the prognosis is better.