高压氧综合救治急性一氧化碳中毒的临床效果分析  

Clinical analysis of hyperbaric oxygen comprehensive treatment of acute carbon monoxide poisoning

作　　者：廖宇忠 LIAO Yu-zhong(Hyperbaric Oxygen Room,Rehabilitation Medicine Department,Xingning People's Hospital,Xingning 514500,China)

机构地区：[1]广东省兴宁市人民医院康复医学科高压氧室,514500

出　　处：《中国实用医药》2025年第5期64-66,共3页China Practical Medicine

摘　　要：目的经验总结高压氧综合救治急性一氧化碳中毒的临床效果。方法300例急性一氧化碳中毒患者,入院确诊后,中重度中毒患者在急诊高压氧治疗前及在脑水肿高峰期5~7 d内入舱前均用甘露醇静脉滴注。应用空气加压舱进行治疗,急诊高压氧治疗压力2.5 ATA,间歇吸氧时间80 min,中间休息5 min;第二次以后压力2 ATA,间歇吸氧时间60 min,中间休息5 min。在首次开始的前5 d,治疗2次/d,治疗间隔时间6~8 h;从第6天开始改为治疗1次/d,10次为1个治疗周期。昏迷时间<30 min者最少治疗10次,根据病情最多给予连续30次高压氧治疗,之后休息10 d,如有必要再行下一阶段治疗。分析患者治疗1个月后的临床疗效。结果所有患者治疗1个月后进行疗效评定,300例患者中,278例(92.67%)患者经高压氧综合救治后痊愈出院;6例(2.00%)恢复良好,有部分脑功能障碍,生活大部分自理;2例(0.67%)重度中毒者好转,有较重脑功能障碍,生活不能自理;6例(2.00%)重度中毒患者未愈,高压氧治疗30次以上仍呈醒状昏迷状;8例(2.67%)中重度中毒患者高压氧治疗疗程不足或合并有基础疾病发生迟发性脑病,经再次入院多疗程高压氧治疗后恢复良好或痊愈。结论对于急性一氧化碳中毒患者,给予及时、充分的高压氧治疗是救治的关键,中重度中毒患者在急诊高压氧治疗前及在脑水肿高峰期5~7 d内入舱前均给予甘露醇静脉滴注,并治疗基础疾病,可提高治愈率,减少迟发性脑病的发生。Objective To summarize the clinical effect of hyperbaric oxygen comprehensive treatment of acute carbon monoxide poisoning.Methods 300 patients with acute carbon monoxide poisoning was reviewed.After the admission,patients with moderate or severe poisoning were treated with intravenous infusion of mannitol before emergency hyperbaric oxygen therapy and within 5-7 d at the peak of cerebral edema;application of pressurized air chambers for treatment,the pressure of the first emergency hyperbaric oxygen treatment was 2.5 ATA,with an intermittent oxygen inhalation of 80 min,and an intermediate rest of 5 min;pressure of the second treatment was 2 ATA,with an intermittent oxygen inhalation of 60 min,and an intermediate rest of 5 min.In the first 5 d of the first treatment,the treatment was given twice a day,with an interval greater than 6-8 h;from the 6th day,the treatment was given once a day,10 treatments as a treatment cycle,and patients who had been unconscious for less than 30 min should receive at least 10 treatments.Depending on their condition,they should receive up to 30 consecutive sessions of hyperbaric oxygen therapy,followed by a 10 day rest period.If necessary,the next stage of treatment can be carried out.Analysis of the clinical efficacy of patients after 1 month of treatment.Results The efficacy of all patients was evaluated after 1 month of treatment.Of the 300 patients,278 cases(92.67%)were cured and discharged after comprehensive treatment with hyperbaric oxygen.6 cases(2.00%)recovered well,with partial cerebral dysfunction,and mostly self-care;2 cases(0.67%)of the severely poisoned patients got better,with heavy cerebral dysfunction,and not self-care;6 cases(2.00%)of the severely poisoned patients were not cured,and were still in coma;8 cases(2.67%)of patients with moderate to severe poisoning had insufficient hyperbaric oxygen treatment courses or delayed encephalopathy in combination with underlying diseases,and recovered well or cured after re-admission to the hospital for multiple courses of hy

关 键 词：一氧化碳 高压氧 综合救治 迟发性脑病 

分 类 号：R47[医药卫生—护理学]