一氧化碳中毒与迟发性脑病的高压氧治疗

目的：观察高压氧治疗急性一氧化碳中毒与迟发性脑病的效果。方法：对129例急性一氧化碳中毒，19例迟发性脑病患者在药物治疗同时加用高压氧治疗。结果：通过高压氧治疗患者的症状、体征、脑电图的改善和治愈率明显提高。结论：对一氧化碳中毒迟发性脑病患者，重在预防，我们认为由昏迷转清醒，决不等于高压氧治疗结束，应多阶段、长疗程高压氧综合治疗，避免和减少迟发性脑病的发生。     

高压氧治疗一氧化碳中毒迟发性脑病

目的探讨一氧化碳中毒迟发性脑病的临床特点、治疗方法及愈后。方法对51例患者临床特点进行分析,并使用高压氧治疗,辅以改善脑循环、代谢的药物及神经康复等综合治疗。结果 51例患者治愈8例,显效15例,有效19例,无效8例,死亡1例。总有效率为82.3%。结论一氧化碳中毒迟发性脑病临床治疗困难、病程长,易并发严重的后遗症及死亡。以高压氧治疗为主的综合治疗,能使处于可逆死亡状态的脑细胞功能得到恢复,是一种有效的治疗方法。     

高压氧为主治疗一氧化碳中毒迟发性脑病

探讨高压氧对一氧化碳中毒迟发性脑病患者的临床疗效及其作用机制。回顾性分析了32例一氧化碳中毒迟发性脑病的临床治疗效果。仅于常规治疗的患者设为对照组(15例)，常规治疗加用高压氧者设为高压氧组(32例)。高压氧治疗压力0．2MPa，吸氧40min 2次，间歇吸空气10min，1次／d，12次为1个疗程。高压氧组总有效率为94％，对照组为73％，两组间总有效率差异有显著性意义(P&;lt;0．05)。高压氧为主治疗是一氧化碳中毒迟发性脑病的有效方法之一，而且治疗时间越早疗效越好，越彻底。     

高压氧治疗急性一氧化碳中毒迟发性脑病的EEG变化

目的:了解高压氧配合药物治疗和单纯药物治疗急性一氧化碳中毒迟发性脑病的EEG动态变化。结果:急性一氧化碳中毒迟发性脑病患者EEG有明显异常,提示EEG可用于急性一氧化碳中毒迟发性脑病的早期诊断,同时有助于了解大脑功能障碍程度,可做为判断病情严重程度、治疗效果及预后的可靠指标。     

高压氧治疗急性一氧化碳中毒迟发性脑病临床分析

目的 探讨高压氧治疗一氧化碳中毒迟发性脑病的临床意义。方法 对103例一氧化碳中毒迟发性脑病患者进行分组治疗,治疗前、后分别对患者进行脑电图、临床疗效分析。结果 高压氧治疗后脑电图较治疗前明显改善;临床症状改善明显,临床症状的改善与脑电图的好转呈平行关系。结论 高压氧治疗一氧化碳中毒迟发性脑病疗效显著;脑电图可指导临床治疗,判定临床疗效。     

高压氧治疗一氧化碳中毒迟发性脑病78例临床分析

目的探讨高压氧治疗一氧化碳中毒迟发性脑病的临床意义。方法对78例一氧化碳中毒迟发性脑病患者进行高压氧治疗，作治疗前、后临床疗效分析。结果高压氧治疗后患者临床症状改善的总有效率为83．3％。结论高压氧对一氧化碳中毒迟发脑病有显著疗效；脑电图对临床治疗和疗效的判定有指导意义。     

高压氧治疗一氧化碳中毒迟发性脑病36例

我院高压氧科共接收CO急性中毒患者 6 2 4例 ,其中 36例经过 10～5 0d不等的“假愈期”后出现迟发性脑病症状 ,及时接受高压氧及药物治疗 ,效果满意。现报告如下。1　资料与方法1 1　一般资料　本组 36例 ,男 2 1例 ,女 15例。年龄 15～ 5 0岁 17例 ,5 0岁以上 19例 ,平均年龄     

高压氧治疗一氧化碳中毒迟发性脑病的疗效观察

目的 探讨高压氧治疗一氧化碳中毒迟发性脑病（DEACMP）的疗效。 方法选取DEACMP患者60例,按照随机数字表法将其分为高压氧组（32例）和对照组（28例）。2组患者均给予改善微循环及康复治疗,高压氧组在此基础上辅以高压氧治疗。治疗前、治疗35d、治疗70d,采用简易智能状态检查量表（MMSE）、BI评分（BI）、年龄相关的白质改变量表（ARWMC）对2组患者的认知功能、运动功能及脑白质损伤程度进行评定。 结果治疗前,高压氧组和对照组MMSE、BI、ARWMC评分之间比较,差异无统计学意义（P&rt;0.05）。与组内治疗前比较,高压氧组治疗35d及70d后MMSE、BI评分均有显著变化,差异有统计学意义（P<0.05）。高压氧组治疗70d后ARWMC评分较治疗前显著降低,差异有统计学意义（P<0.05）。治疗35d后,高压氧组MMSE评分［(10.78±4.41)分］高于对照组［(2.54±1.50)分］（P<0.05),BI评分［(48.75±11.85)分］高于对照组BI评分［(9.46±6.43)分］(P<0.05),其ARWMC评分与对照组ARWMC评分之间比较,差异无统计学意义（P&rt;0.05）。治疗70d后,高压氧组MMSE评分［(23.69±3.79)分］高于对照组［(2.89±1.64)分］( P<0.05),BI评分［(75.78±16.37)分］高于对照组BI评分［(12.14±8.65)分］(P<0.05),其ARWMC评分［(7.13±3.22)分］低于对照组［(15.79±4.70)分］(P<0.05)。 结论在改善微循环治疗及康复训练基础上,高压氧能够改善DEACMP患者的认知功能及运动功能,治疗70d后可显著减轻患者脑白质的损伤程度。     

高压氧治疗一氧化碳中毒迟发性脑病的体会

宁夏医学院附属医院自1986-07／2002-12采用高压氧脑梗死及其后遗症患共558例，获得了满意效果。     

高压氧液治疗急性一氧化碳中毒36例疗效观察

目的：探讨高压氧液治疗急性一氧化碳（carbon monoxide，简称CO)中毒的疗效。方法：该科从2002年1月～2003年6月收治急性CO中毒病人72例，随机分为2组，治疗组36例常规治疗加高压氧液治疗，对照组给常规治疗，评价两组疗效。结果：高压氧液组血氧饱和度(SaO2)、血二氧化碳分压(PaCO2)、全血粘稠度(BV)、血浆粘稠度(PV)改善程度明显优于对照组，高压氧液组在苏醒时间、治愈时间方面明显短于对照组。结论：高压氧液疗能迅速改善急性CO中毒患者机体缺氧情况，促进清醒，减少并发症发生，疗效确切。     

Hyperbaric Oxygen Does Not Prevent Neurologic Sequelae after Carbon Monoxide Poisoning

Delayed neurologic sequelae occur in up to 40% of severe carbon monoxide (CO) poisonings. Conflicting clinical data support the efficacy of hyperbaric oxygen (HBO) therapy in the acute treatment of CO poisoning. OBJECTIVE: To determine whether oxygen therapy reduces neurologic sequelae after CO poisoning in mice. METHODS: Male Swiss-Webster mice were exposed to CO at 1,000 ppm for 40 minutes and then 50,000 ppm until loss of consciousness (LOC) (4-9 additional minutes). Total time of both phases of CO exposure was 40-49 minutes. Treatment included HBO with 3 atmospheres (ATA) 100% oxygen, normobaric oxygen (NBO) with 1 ATA 100% oxygen, or ambient air 15 minutes after LOC. All animals underwent passive avoidance training and memory was assessed by measuring step-down latency (SDL) and step-up latency (SUL) seven days following CO exposure. RESULTS: Carbon monoxide poisoning induced significant memory deficits (SDL(CO) = 156 sec; SUL(CO) = 75%) compared with nonpoisoned (NP) animals (SDL(NP) = 272 sec; SUL(NP) = 100%). Both HBO and NBO did not prevent these neurologic sequelae. Furthermore, no significant neurobehavioral differences were found between HBO and NBO. Histologic examination of the CA1 layer of the hippocampus for pyknotic cells showed significant damage from CO in the air-treated animals (9.6%) but not in the nonpoisoned animals (3.8%). No significant neuroprotection was seen histologically with NBO and HBO compared with ambient air. CONCLUSIONS: These results suggest that HBO is not effective in preventing neurologic sequelae in mice and that there is no benefit of HBO over NBO following severe CO neurotoxicity.     

Seizure During Hyperbaric Oxygen Therapy for Carbon Monoxide Toxicity: A Case Series and Five-year Experience

Background: Hyperbaric oxygen (HBO) therapy is recommended to reduce the delayed neurologic sequelae resulting from carbon monoxide (CO) toxicity. Although HBO is generally well tolerated, there exists a risk of seizure in all patients that may be increased in patients with predisposing factors including: fever, hypothermia, prior seizure, or brain injury. Case Report: We present two cases of patients without known risk factors who experienced seizures associated with HBO therapy during treatment for CO toxicity. Conclusion: This facility's 5-year experience and a review of the germane literature are also presented to elucidate the risk factors and incidence of seizures in patients treated with HBO for CO toxicity.     

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.     

血必净注射液治疗重度急性一氧化碳中毒30例临床分析

目的:探讨血必净注射液治疗重度急性一氧化碳中毒的临床疗效。方法:60例重度急性一氧化碳中毒患者随机分为治疗组和对照组各30例,对照组给予高压氧等常规治疗,治疗组在常规治疗基础上加用血必净注射液,比较两组临床疗效。结果:治疗组患者神志清醒时间较对照组明显缩短(P0.01);治疗组总有效率高于对照组(P0.05);治疗组急性一氧化碳中毒迟发性脑病发生率明显低于对照组(P0.05)。结论:在常规治疗的基础上,合用血必净注射液治疗重度急性一氧化碳中毒可提高临床疗效,减少急性一氧化碳中毒迟发性脑病的发生率。     

一氧化碳中毒迟发性脑病高压氧治疗剂量与疗效

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。     

高压氧治疗急性一氧化碳中毒迟发性脑病63例

【目的】探讨高压氧对CO中毒迟发性脑病的治疗作用。【方法】分析我科收治的CO中毒迟发性脑病患者的病史 ,以及高压氧治疗及其疗效。【结果】所有病人均为不同程度的中度CO中毒病人 ,患迟发性脑病前所有病人均进行了及时的和系统的药物治疗 ,其中 2 6例未曾进行高压氧治疗 ,其余患者虽曾作过高压氧但不及时或疗程不够 ,即及时适量的高压氧治疗没有一例 ;发生迟发性脑病之后高压氧疗程与总有效率为 :2、3、>3疗程的总有效率分别是 6 6 .9%、92 %和 10 0 %。【结论】及时和适量的高压氧治疗对CO中毒迟发性脑病有显著的预防和治疗作用。     

Hyperbaric Oxygen Therapy Did Not Prevent Delayed Neuropsychiatric Sequelae in a Prospective Observational Study With Propensity Score Matching in 224 Patients With Acute Carbon Monoxide Toxicity

BackgroundIt is important to prevent the development of delayed neuropsychiatric sequelae (DNS) in acute carbon monoxide (CO) intoxication, but no effective treatment has been clearly identified. Hyperbaric oxygen (HBO) therapy is one of the treatment options in acute CO poisoning; however, whether it can prevent the development of DNS is controversial.ObjectivesThe purpose of this study is to compare the effectiveness of normobaric oxygen (NBO) and HBO in preventing DNS.MethodsThis prospective observational study was conducted on all patients with CO poisoning admitted to the emergency department of a tertiary hospital from 2016 to 2019. We followed-up patients to determine whether symptoms of DNS occurred at ≤6 months. We matched the propensity score to an equivalent distribution of potential covariates.ResultsA total of 224 patients with CO poisoning were enrolled in this study. NBO was used for 26 patients and HBO for 198 patients. DNS occurred in 40 patients. There were significant differences between the NBO and HBO groups in terms of carboxyhemoglobin, loss of consciousness, dizziness, chest pain, hospitalization, and length of hospital stay. The incidence of DNS was 19.2% in the HBO group, which was higher than the 7.7% observed in the NBO group, but the difference was not significant (p = 0.18). After propensity score matching, the incidence of DNS did not differ between the NBO and HBO groups (8.3% vs. 10.4%, p > 0.99).ConclusionThere was no difference in the incidence of DNS between groups receiving HBO and NBO in acute CO intoxication.