氧疗联合羟钴胺治疗火灾烟气中毒的实验研究  

Experimental study on oxygen therapy combined with hydroxycobalamin in the treatment of fire smoke poisoning

作　　者：郭海东 杨润芳[2] 何瑾[1] 刘军军 李宏霞 GUO Haidong;YANG Runfang;HE Jin;LIU Junjun;LI Hongxia(Sichuan Fire Research Institute of Ministry of Emergency Management,Chengdu Sichuan 610036,China)

机构地区：[1]应急管理部四川消防研究所,四川成都610036 [2]四川大学华西医院,四川成都610041

出　　处：《中国急救复苏与灾害医学杂志》2022年第2期164-167,178,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：公安部技术研究计划面上项目(编号:2017JSYJC34);应急管理部四川消防研究所基本科研业务专项(编号:20188804Z,T2019881102)。

摘　　要：目的探讨氧疗联合羟钴胺治疗火灾烟气中毒的有效性及安全性,为火灾伤员的应急处置和后续治疗研究提供参考。方法60只SD大鼠随机分为3组,即空白对照组、中毒组、联合治疗组,每组20只,雌雄各半。空白对照组不作任何处理,中毒组选取市售羊绒毛线,按GB/T 20285-2006《材料产烟毒性危险分级》设计的产烟装置设定产烟浓度为35 mg/L,染毒30 min,染毒成功的10只动物1 h后股动脉采血,测定血液中碳氧血红蛋白饱和度(COHb%)、CN^(-)、乳酸浓度。联合治疗组染毒成功后,立即腹腔注射羟钴胺200 mg/kg,吸氧(浓度>95%)30 min,同样的方法测定其中10只大鼠血液中COHb%、CN^(-)、乳酸浓度,考察干预措施的有效性;中毒组和联合治疗组剩余10只染毒成功的动物观察24 h后解剖,行血生化、血常规及组织病理学检查,考察干预措施的安全性。结果染毒结束后,动物呈明显的中毒症状,表现为四肢无力、呼吸浅弱,偶伴惊厥抽搐。腹腔注射羟钴胺并吸氧30 min后,动物状态明显好转,呼吸正常,除观察到药物注射动物出现由羟钴胺自身的深红色导致的色素尿和皮肤发红外,未见明显异常。血液检查发现联合治疗组血液中COHb%、CN^(-)、乳酸浓度显著低于中毒组(P<0.05),但COHb%、乳酸浓度仍大于空白对照组(P<0.05)。血常规、血生化及组织病理学检查未见明显异常。结论氧疗联合羟钴胺腹腔注射可以有效缓解大鼠烟气中毒的症状,同时具有较高的安全性,可以为开展火场伤员的应急处置和治疗措施研究提供参考。Objective To explore the efficacy and safety of oxygen therapy combined with hydroxycobalamin injection in the treatment of fire smoke poisoning,so that to provide research reference for emergency and follow-up treatment of fire wounded.Methods 60 SD rats were randomly divided into three groups:blank control group,poisoned group and combined treatment group,with 20 rats in each group,half male and half female.Animals in the blank control group were fed with normal diet without any treatment.For the poisoned group,cashmere wool sold in the market was selected,exposures were carried out in a smoke producing device according to GB/T 20285-2006:Classification of Smoke Toxicity Risk of Material,setting the smoke concentration was 35 mg/L,after 30 minutes of exposure,the poisoned animals were taken out,1 hour later,blood was collected from femoral artery,and the changes of COHb%,CN^(-),lactate concentration were measured.For the combined treatment group,intraperitoneal injection of hydroxycobalamin 200 mg/kg was conducted immediately after poisoning,and then inhalation of oxygen(concentration more than 95%)for 30 min;the same methods were conducted to collect blood sample and to exam the changes of COHb%,CN^(-),lactate concentration in 10 rats,so that to investigate the effectiveness of intervention measures.The remaining 10 rats in the poisoned and combined treatment groups were observed for 24 hours,then the rats were dissected,blood biochemical indexes,blood routine examination and histopathological examination were carried out to exaruine the safety of the intervention measures.Results At the end of expolive,the rats showed obvious symptoms of poisoning,weakness of limbs,shallow breathing,and convulsion and so on.After intraperitoneal injection of hydroxycobalamin and oxygen inhalation for 30 minutes,the rats were in a better state,showed normal breathing.In addition to the observation that the injected animals had pigmented urine and skin infrared caused by the dark red of hydroxycobalamin itself,no obvious abnorm

关 键 词：火灾烟气 一氧化碳 氰化物 中毒 现场救护 实验研究 

分 类 号：R459.7[医药卫生—急诊医学]