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一氧化碳中毒后的肺血栓栓塞症。

Pulmonary thromboembolism after carbon monoxide poisoning.

机构信息

Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.

Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.

出版信息

Am J Emerg Med. 2018 Sep;36(9):1717.e3-1717.e7. doi: 10.1016/j.ajem.2018.05.063. Epub 2018 May 29.

Abstract

OBJECTIVE

Carbon monoxide (CO) poisoning is known to increase thrombotic tendency, and the risk of deep vein thrombosis in individuals who have experienced CO poisoning is higher than in the general population. However, there are a few reports describing cases of pulmonary thromboembolisms (PTE) secondary to CO poisoning.

DATA SOURCES

Retrospective data analysis.

STUDY SELECTION

Seven hundred fifty bed tertiary university affiliated hospital.

DATA EXTRACTION AND SYNTHESIS

Five patients with PTE after CO poisoning were observed. Two patients experienced cardiac arrest; they were treated successfully with tissue plasminogen activators and targeted temperature management. Their cerebral performance scores at discharge were both 1. Three patients had PTE and were treated with anticoagulation.

CONCLUSIONS

To date, the causal relationship between PTE and CO poisoning is unclear. However, PTE should be considered in patients with CO poisoning as a differential diagnosis when unexplained hypoxemia or shock are observed. Further studies on the association between CO poisoning and PTE are warranted.

摘要

目的

一氧化碳(CO)中毒已知会增加血栓形成倾向,经历过 CO 中毒的个体发生深静脉血栓的风险高于普通人群。然而,有少数报告描述了继发于 CO 中毒的肺血栓栓塞症(PTE)病例。

资料来源

回顾性数据分析。

研究选择

750 张床位的三级大学附属医院。

资料提取与综合

观察了 5 例 CO 中毒后发生 PTE 的患者。2 例患者发生心脏骤停;他们均成功接受了组织型纤溶酶原激活物和靶向体温管理治疗。出院时他们的大脑功能评分均为 1 分。3 例患者患有 PTE,并接受抗凝治疗。

结论

迄今为止,PTE 与 CO 中毒之间的因果关系尚不清楚。然而,当观察到不明原因的低氧血症或休克时,应将 PTE 作为 CO 中毒的鉴别诊断。有必要进一步研究 CO 中毒与 PTE 之间的关联。

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