机械通气与鼻导管吸氧抢救重度CO中毒的疗效比较  

The efficacy comparison of the mechanical ventilation and oxygen inhalation via nasal tube in rescuing serious carbon monoxide poisoning patients

作　　者：何勇[1] 郭焱雄[1] 段丛菊[1] 李军[1] 

机构地区：[1]郴州市第一人民医院南院急诊科,湖南郴州423000

出　　处：《湘南学院学报（医学版）》2017年第3期10-13,共4页Journal of Xiangnan University（Medical Sciences）

基　　金：湖南省卫生和计划生育委员会科研基金课题资助(编号B2013-154)

摘　　要：目的探讨机械通气和鼻导管吸氧对无法立即行高压氧治疗的一氧化碳(CO)中毒患者的疗效,为抢救此类患者提供临床指导。方法将93例无法行高压氧治疗的重度CO中毒患者随机分为机械通气组(n=47)和吸氧组(n=46),分别使用机械通气和鼻导管吸氧两种治疗方法,观察并分析两组治疗效果。结果经治疗后,机械通气组死亡3例,有效30例,发生CO中毒迟发性脑病14例,从入院至开始高压氧的时间(48.5±9.2)h,发生院内获得性肺炎及呼吸机相关性肺炎12例;吸氧组死亡7例,有效11例,发生CO中毒迟发性脑病28例,从入院至开始高压氧的时间(78.3±15.9)h,发生院内获得性肺炎及呼吸机相关性肺炎2例。与吸氧组者比较,机械通气组的有效率高、从入院至开始高压氧的时间短、CO中毒迟发性脑病发生率低(P<0.05),但院内获得性肺炎及呼吸机相关性肺炎发生率高(P<0.05)。结论当无法立即行高压氧治疗的CO中毒,积极行机械通气是一种合适的治疗方法,但需要积极预防呼吸机相关性肺炎。Objective To investigate the efficacy of mechanical ventilation and oxygen inhalation via nasal tube on the carbon monoxide poisoning patients who could not be treated by Hyperbaric oxygen immediately in order to provide clinical guidance for giving emergency treatment to these patients.Methods 93 cases of serious CO poisoning patients who could not be treated by HBO were randomly divided into two groups-the mechanical ventilation group（ n = 47） and the oxygen inhalation group（ n = 46） which could be given two different treatments and the therapeutic effects were observed and analyzed. Results Through different treatments,when compared the mechanical ventilation group with the oxygen inhalation group,many observe items are better [death 3 vs 7 cases; cured 30 cases vs 11 cases; DEACMP 14 cases vs 28 cases; latency to HBO（ 48.5±9.2） h vs（ 78.3±15.9） h; HAP and VAP 12 VS 2 cases]. The mechanical ventilation group has a higher efficiency,a shorter time from being admitted to hospital to starting HBO and a lower occurrence rate of DEACMP（ P0.05）,but it has a higher occurrence rate of HAP and VAP（ P0.05）.Conclusion Mechanical ventilation is an appropriate treatment for CO poisoning when HBO cannot be available immediately,but ventilator associated pneumonia should be prevented.

关 键 词：机械通气 吸氧 CO中毒 

分 类 号：R595[医药卫生—内科学]