急性一氧化碳中毒合并横纹肌溶解症的急救体会  

Emergency treatment experience of acute carbon monoxide poisoning complicated with rhabdomyolysis

作　　者：陈洪云[1] 刘玲[1] 高英[1] 喻红[1] Chen Hongyun;Liu Ling;Gao Ying;Yu Hong(Department of Emergency,Anshun People's Hospital of Guizhou Province,Anshun 561000,Guizhou,China)

机构地区：[1]贵州省安顺市人民医院急诊科,贵州安顺561000

出　　处：《中国中西医结合急救杂志》2020年第4期484-485,共2页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：贵州省安顺市科技计划项目(安市科合〔2011〕号)。

摘　　要：目的观察急性一氧化碳中毒(ACOP)合并横纹肌溶解症(RM)的临床疗效。方法采用回顾性研究方法,收集贵州省安顺市人民医院收治的2例ACOP合并RM患者的临床资料,分析其一般资料、阳性体征、实验室检查结果、影像学改变、治疗和转归,分享治疗经验。结果2例患者均因接触煤气后出现头晕、腹痛、上肢无力疼痛入院;实验室检查可见尿素氮(BUN)、肌酐(Cr)、天冬氨酸转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌红蛋白(Myo)、肌酸激酶同工酶(CK-MB)等异常。入院诊断为ACOP,RM。给予吸氧、脱水防治脑水肿、容量复苏、碱化尿液、利尿、改善微循环、激素等对症支持综合治疗。例2患者给予高压氧治疗。2例患者经治疗后双上肢肿胀、压痛及肌无力等临床症状、实验室指标均较入院时明显改善,病情好转出院。结论采用综合方法,必要时加用高压氧治疗ACOP合并RM患者后,临床症状改善,疗效良好。Objective To observe the clinical effect of acute carbon monoxide poisoning(ACOP)combined with rhabdomyolysis(RM).Methods Using retrospective research methods,the clinical data of two patients with ACOP and RM admitted in Anshun People's Hospital of Guizhou Province were collected,and the general data,positive signs,laboratory examination results,imaging changes,treatment and outcome were analyzed to share the treatment experience.Results Two patients were admitted to hospital because of dizziness,abdominal pain and upper limb weakness pain after exposure to gas;laboratory examination showed abnormalities of blood urea nitrogen(BUN),creatinine(Cr),aspartate transaminase(AST),creatine kinase(CK),lactate dehydrogenase(LDH),myoglobin(Myo),and creatine kinase-MB(CK-MB).The diagnosis was ACOP and RM.Oxygen,dehydration for prevention and treatment of brain edema,volume recovery,alkalization of urine,diuresis,improvement of microcirculation,hormone and other symptomatic support combined treatments were given.In case 2,hyperbaric oxygen therapy was given.After treatment,the clinical symptoms,such as swelling of both upper limbs,tenderness,myasthenia and laboratory indexes of the two patients were significantly improved compared with those at admission,and the patients were discharged.Conclusions The comprehensive methods were used.If necessary,hyperbaric oxygen was added to treat ACOP with RM.The clinical symptoms were improved and the curative effect was good.

关 键 词：一氧化碳中毒 急性 横纹肌溶解症 急救 

分 类 号：R59[医药卫生—内科学]