高压氧治疗急性一氧化碳中毒疗效观察

目的观察高压氧对急性一氧化碳中毒的疗效。方法急性一氧化碳中毒患者除常规治疗外均加用高压氧治疗。结果高压氧治疗急性一氧化碳中毒总有效率为96%,高压氧治疗急性一氧化碳中毒疗效显著。     

纳洛酮联合高压氧治疗急性重度一氧化碳中毒的疗效观察

[目的]观察纳洛酮联合高压氧治疗急性重度一氧化碳中毒的疗效.[方法]对本院收治的40岁以上、无心脑血管疾病等的急性重度一氧化碳中毒患者197例,随机分为两组.其中99例为治疗组,另98例为对照组,对照组仅采用高压氧治疗,治疗组给予纳洛酮联合高压氧治疗.[结果]治疗组治愈率高于对照组（P〈0.05）,治疗组患者意识障碍恢复明显优于对照组,平均昏迷时间明显短于对照组,且后遗症的发病率明显低于对照组,两组相比差异均有显著性（P〈0.01）.[结论]纳洛酮联合高压氧用于治疗重度急性一氧化碳中毒安全高效,值得临床推广.     

醒脑静注射液配合高压氧治疗急性一氧化碳中毒疗效观察

目的 :观察醒脑静注射液配合高压氧治疗急性一氧化碳 (CO)中毒的疗效。方法 :急性 CO中毒患者分 2组治疗。 2组常规治疗相同 ,对照组 (4 6例 )加用高压氧治疗 ,治疗组 (31例 )加用醒脑静注射液静滴和高压氧治疗 ,观察 2组疗效。结果 :醒脑静治疗组与对照组总有效率分别为 87.1%和 6 7.4% ,发生迟发脑病例数分别为 2例和 6例 ,2组比较均有显著差异 (P均 <0 .0 5 )。结论 :醒脑静注射液配合高压氧治疗急性 CO中毒能明显提高总有效率 ,缩短意识恢复时间 ,减少迟发脑病的发生 ,且无不良反应     

高压氧联合纳洛酮治疗急性一氧化碳中毒疗效观察

评价高压氧联合纳洛酮治疗急性一氧化碳中毒的疗效。方法：治疗组：高压氧联合纳洛酮对66例患者进行治疗;对照组：高压氧对64例患者进行治疗。结果：72h后治疗组Glascow评分（GCS）明显高于对照组,治愈率高于对照组,后遗症及病死率显著低于对照组。结论：高压氧和足量纳洛酮早期联合应用,对急性一氧化碳中毒患者,具有较好疗效。     

急诊高压氧对急性一氧化碳中毒治疗的临床疗效观察

目的：探讨高压氧对急性一氧化碳中毒治疗的临床意义。方法：对120例急性一氧化碳中毒患者除常规治疗外,均施行急诊高压氧治疗。结果：接受急诊高压氧治疗的急性一氧化碳中毒患者有效率达100%。结论：高压氧对急性一氧化碳中毒的治疗有显著疗效。     

高压氧治疗前后急性一氧化碳中毒心肌酶谱的变化

急性一氧化碳(CO)中毒为常见的急性中毒，而中、重度中毒患常合并明显的心肌损害。我院急诊科2000-10-2003-09共收治急性CO中毒216例，对其中重度中毒38例在高压氧治疗前后进行了心肌酶的动态监测，现报告如下。     

高压氧治疗急性CO中毒

一氧化碳（CO）中毒是世界各国因中毒导致损伤和死亡的主要原因之一。我国北方每年冬季因取暖造成一氧化碳中毒死亡、致残患者数量不少，对社会造成极大的危害。目前，大量临床实践研究表明，高压氧是治疗急性CO中毒及迟发型脑病的有效手段。     

早期高压氧对一氧化碳中毒迟发性脑病的治疗预防

目的：早期高压氧治疗一氧化碳中毒,预防一氧化碳中毒迟发性脑病。方法：60例一氧化碳中毒患者早期应用高压氧及药物综合治疗,50例患者用药物治疗进行对照。结果：昏迷时间治疗组比对照组明显缩短;迟发性脑病治疗组发生率3.3%,对照组发生率38%;治愈率治疗组97%,对照组52%,两组比较差异有显著性（P〈0.05）。结论：早期应用高压氧加药物综合治疗和充足的疗程是预防一氧化碳中毒迟发性脑病的关键。     

Acute Carbon Monoxide Poisoning Risk of Late Sequelae and Treatment by Hyperbaric Oxygen

Abstract

The indications for hyperbaric oxygen therapy (HBO) in the treatment of acute carbon monoxide (CO) poisoning are discussed far too little in the literature. Depending on the author reasons for referral to a hyperbaric center include the carboxyhemoglobin level, change in state of consciousness or neurological abnormalities. In our opinion, HBO should be used on much wider indications than is usual, not only because of the rapid relief from symptoms it provides but mainly because it may prevent severe delayed sequelae. During a period of 9 months 230 patients with CO poisoning were admitted to our intensive care unit; 203 were treated with HBO and 27 with normobaric oxygen. Our indications for HBO treatment were: coma, pathological neurological findings or loss of consciousness during CO exposure irrespective of normal clinical findings on admission. Four patients died and the others were discharged 12 hours to 25 days after the incident. Seven patients had minor neurological problems within two weeks of discharge and which disappeared within one month. Two patients were re-hospitalized for neuropsychiatry sequelae and recovered in 3 and 6 months respectively. Neither the clinical status upon admission nor COHb predicted the outcome of the poisoning.

Referral to a HBO center should be considered when:

• the patient is comatose

• there are abnormal clinical findings

• patients have been unconsciousness during exposure, irrespective of whether they are conscious on admission and have normal clinical status.

     

Hyperbaric Oxygen in the Treatment of Carbon Monoxide Poisoning

Carbon monoxide, a byproduct of incomplete hydrocarbon combustion, has been responsible for many accidental poisonings worldwide. The signs and symptoms of poisoning are diverse, ranging from headache, dizziness, and confusion to cardiac and neurological disturbances. Oxygen is the cornerstone of treatment, because it accelerates the dissociation of carbon monoxide from heme proteins. The role of hyperbaric oxygen in the treatment of CO poisoning is still questionable. Only a few randomized, controlled studies have been conducted, and their results are inconsistent. In the present review, we discuss the conclusions of four randomized controlled studies and propose a hyperbaric oxygen treatment protocol based on these conclusions.     

纳洛酮治疗急性一氧化碳中毒所致昏迷临床观察

急性一氧化碳中毒发生后常会出现不同程度的意识障碍，以昏迷危害最大。我科应用纳洛酮配合高压氧治疗后，效果显著，报告如下。     

静舒氧治疗重度一氧化碳中毒的疗效观察

目的观察静舒氧治疗重度一氧化碳(CO)中毒的效果.方法 72例患者随机分为观察组38例,对照组34例.观察组在常规治疗基础上予静舒氧,对照组予面罩给氧.观察两组治疗效果,并进行对照比较.结果与对照组相比,观察组不同时刻格拉斯哥(GCS)评分均有提高,3h差异显著(P<0.05),6～24h差异非常显著(P<0.01),观察组治愈率、后遗症发生率均低于对照组(P<0.01;P<0.05).结论静舒氧治疗CO中毒疗效好,且无不良反应,使用方便,值得临床推广应用.     

静舒氧治疗重度一氧化碳中毒的疗效观察

目的观察静舒氧治疗重度一氧化碳(CO)中毒的效果。方法72例患者随机分为观察组38例,对照组34例。观察组在常规治疗基础上予静舒氧,对照组予面罩给氧。观察两组治疗效果,并进行对照比较。结果与对照组相比,观察组不同时刻格拉斯哥(GCS)评分均有提高,3h差异显著(P<0.05),6～24h差异非常显著(P<0.01),观察组治愈率、后遗症发生率均低于对照组(P<0.01;P<0.05)。结论静舒氧治疗CO中毒疗效好,且无不良反应,使用方便,值得临床推广应用。     

Pathophysiology and Treatment of Carbon Monoxide Poisoning

Abstract

Carbon monoxide poisoning is the leading cause of poisoning deaths in the US, and published reports of carbon monoxide related morbidity and mortality can vary widely. Common morbidity involves myocardial and/or neurologic injury including delayed neurologic sequelae. The pathophysiology of this entity is complex, involving hypoxic stress on the basis of interference with oxygen transport to the cells and possibly impairing electron transport. Carbon monoxide can also affect leukocytes, platelets and the endothelium, inducing a cascade of effects resulting in oxidative injury. Carboxyhemoglobin levels are valuable for confirming carbon monoxide exposure but cannot be used to stratify severity of poisoning, predict prognosis, or indicate a specific treatment plan. Oxygen therapy is the key treatment of carbon monoxide intoxication, and hyperbaric oxygen has been shown to interdict and improve clinical outcome in some patients. Immediate treatment with a high fraction of inspired oxygen and careful clinical evaluation are mandatory. Timely referral for hyperbaric oxygen is indicated for patients with any history of unconsciousness, cardiovascular instability or ischemia, and persistent mental and/or neurologic deficits. Hyperbaric oxygen should also be considered in certain other patient subsets.     

一氧化碳中毒迟发性脑病58例临床研究

目的 探讨一氧化碳(CO)中毒迟发脑病的临床特点、发病相关因素及高压氧治疗的作用.方法 回顾性分析58例确诊的CO中毒迟发脑病患者的临床资料.结果 58例中,发生在低浓度、长时间CO环境者占81.0%,昏迷4 h以上者占67.2%,年龄40岁以上者占70.7%,未正规行药物及高压氧综合治疗者占93.1%.坚持高压氧综合治疗后痊愈及生活基本自理者占84.2%,影像学表现恢复率为87.9%.结论 CO中毒迟发脑病的发生与中毒原因、病情轻重、年龄、合理治疗与否有密切关系,高压氧对本病的预防和治疗具有重要的作用.     

急性一氧化碳中毒与不同疾患同舱高压氧治疗优先吸氧的效果观察

每年入冬后 ,基层医院常常遇到急性一氧化碳中毒与常规做高压氧治疗的其他病人在治疗时间上发生冲突的情况 ,有时因经济方面原因一氧化碳中毒者不愿单独开舱抢救 ,而常规治疗者多是从乡镇赶车而来 ,在只有 1台中型氧舱的情况下 ,为了既不耽误抢救又不影响常规治疗 ,我们常合为一舱处理。一氧化碳中毒病人易在升压阶段出现病情变化 ,而标准治疗方案在升压阶段不吸氧 ,必须在稳压下吸氧治疗。针对该情况 ,我们本着“不超过安全时程范围”的宗旨 ,对常规治疗方案进行了改进 ,采取同舱治疗 ,一氧化碳病人优先吸氧 ,其他病人稳压吸氧的方法 ,并对…     

大剂量纳洛酮抢救急性CO中毒的疗效观察

目的:探讨不同剂量纳洛酮在急性CO中毒中的疗效。方法:本研究62例急性CO中毒患者按常规量及大剂量治疗,观察两组病例在平均催醒时间及症状消失时间和毒副反应方面有无差异。结果:两组病例在平均催醒时间,症状消失时间方面差别显著(P<0.01),两组病例均无明显毒副反应。结论:大剂量组从平均催醒时间及症状消失时间均优于常规剂量组,毒副反应少。