摘要
目的探讨急性一氧化碳中毒患者的发病特点、临床表现及不同治疗方法的疗效。方法回顾性分析1998年1月至2005年4月我院收治的312例急性一氧化碳中毒患者的中毒原因、发病年龄、性别、职业特点及临床表现、不同治疗方法的疗效。结果急性一氧化碳中毒居室煤烟吸入占中毒原因的首位为84·6%(264/312),职业性中毒占2·9%(9/312);职业分布农民工占76·6%(239/312);87·1%(272/312)的中毒事件发生在冬春季节。头痛、头晕、恶心、乏力、意识障碍为主要症状;碳氧血红蛋白检测阳性率为52·9%;心肌酶谱和心电图异常率分别为52·2%和20·5%。昏迷≥4h组脑水肿、肺水肿发生率分别为51·3%和15·8%,显著高于<4h组(20·9%,P<0·01;4·84%,P<0·05)。血磁联合治疗组治愈率为91·7%,显著高于常规治疗组(40%,P<0·01)和高压氧治疗组(66·7%,P<0·05)。结论一氧化碳接触史对急性一氧化碳中毒诊断具重要提示价值;意识障碍则是分级的主要依据;其严重并发症与昏迷时间密切相关;血磁联合治疗可提高其治愈率,并降低迟发脑病的发生率。
Objective To observe features their onset and clinical manifestations in patients with acute carbon monoxide poisoning （ACMP）, as well as effectiveness of varied therapies for them. Methods Data of 312 patients with ACMP hospitalized during January 1998 to April 2005 were analyzed retrospectively, in terms of their gender, age at onset, occupation, cause of poisoning, clinical features and effectiveness of different treatments. Results Of 312 patients with ACMP,84. 6% of them were caused by inhalation of indoor coal-burning smoke at their residence and 2. 9% caused by occupational exposure. And,76.6% of them were laborers immigrated from rural areas, and 87.1% of poisoning accidents happened in the winter and early spring. No gender difference in attack rate of ACMP was found. Age of the patients averaged 45.8 years. Coma in the patients lasted for 52. 3 hours in median, with main symptoms of headache, dizziness, nausea, weakness and disturbance of consciousness. Carboxyhemoglobin was detected in 52. 9% of these patients, abnormal myocardial enzymogram in 52. 2% and abnormal electrocardiograms in 20.5% ,respectively. Cerebral edema occurred in 51.3% and pulmonary edema in 15.8% of the patients with coma for more than four hours, significantly higher than those with coma for less than four hours （20. 9% ,P 〈 0. 01 and 4. 84%, P 〈 0.05）. Cure rate in those of combined therapy with magnet- and uhraviolet-disposed blood was 91.7% , significantly higher than those with both routine therapy （40% , P 〈 0. 01 ） and hyperbaric oxygenation （ 66.7%, P 〈 0. 05 ） . Conclusions History of exposure to carbon monoxide followed by relevant symptoms provides the most important evidence for diagnosis of ACMP, and classification of the poisoning is mainly based on their disturbance of consciousness. Severe complications of ACMP related closely to the period of persistence of coma. Combined therapy with patients＇ own blood disposed with magnetic field and ultraviolet can improve their cure rate and lower incidence of delayed encephaloDathv.
出处
《中华全科医师杂志》
2005年第11期659-662,共4页
Chinese Journal of General Practitioners
关键词
一氧化碳中毒
诊断
治疗结果
高压氧
紫外线疗法
Carbon monoxide poisoning
Diagnosis
Treatment outcome
Hyperbaric oxygenation
Ultraviolet therapy
