重度一氧化碳中毒性肺水肿急诊集束治疗分析

目的 探讨重度一氧化碳中毒性肺水肿急诊处置方法。方法重度一氧化碳中毒性肺水肿患者12例，急诊处置采用集束治疗，要点：①保护性通气间断纯氧氧疗。②甲基强的松龙240mg／d，静脉点滴。③6％羟乙基淀粉钠500ml＋10％氯化钠60ml＋速尿100mg，200ml／h，恒速泵入。结果显效9例（75．0％），有效3例（25．0％）。氧合指数（203．4±69．7）VS（434．6±973X）（P〈0．01）。X线胸片的变化显效8例（66．7％），有效4例（33．3％）。本组12例患者经后续高压氧等综合治疗，均治愈出院，其中，发生迟发性脑病1例。结论集束治疗可能是重度一氧化碳中毒性肺水肿的有效方法。

Analysis on bundles treatment in emergency in patients with severe carbon monoxide toxic pulmonary edema

Objective To investigate the methods in emergency treatment for patients with severe carbon monoxide toxic pulmonary edema.Methods The 12 cases patients with severe carbon monoxide carbon monoxide toxic pulmonary edema were treated with the emergency methods with bundles 60 mL+500 mL+furosemide 100 mg,200 ml/h,intravenous pump on constant speed.Results Markedly effective in 9 cases(75.0%),effective in 3 cases(25.0%).Oxygenation index.is(203.4±69.7)VS(434.6±97.3),t=10.045,P＜0.01.X-ray changes is markedly effective in 8 cases(66.7%),effective in 4 cases(33.3%).The 12 eases were all cured after treatment by hyperbaric oxygen and other comprehensive follow-up treatment,including 1 case with delayed encephalopathy.Conclusion It may be an effective way to use bundles treatment for severe carbon monoxide toxic pulmonary edema.