Yang Lu, Nan Ding, Liu Xuehua, Zhang Jing, Zhang Yi, Liang Fang, Zhu Wanqiu, Yang Jing
Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Med Gas Res. 2026 Mar 1;16(1):6-11. doi: 10.4103/mgr.MEDGASRES-D-25-00109. Epub 2025 Jun 28.
JOURNAL/mgres/04.03/01612956-202603000-00002/figure1/v/2025-06-28T140100Z/r/image-tiff Paroxysmal sympathetic hyperactivity syndrome (PSH) is common in patients with severe craniocerebral injuries. Carbon monoxide poisoning (ACOP) may lead to secondary PSH, and hyperbaric oxygen (HBO) is an important treatment method for ACOP that can promote the dissociation of carboxyhemoglobin and reduce the long-term sequelae of ACOP. To explore the risk factors and clinical characteristics of PSH secondary to acute ACOP and to investigate the efficacy of HBO treatment, a retrospective analysis was performed on patients with moderate to severe ACOP admitted to the Hyperbaric Oxygen Department of Beijing Chaoyang Hospital, Capital Medical University, from January 1, 2018 to December 31, 2024. Three patients developed PSH during hospitalization and were classified into the PSH group, while the remaining 50 patients were in the non-PSH group. Univariate Fisher's exact test indicated that a coma duration of more than 72 hours was related to the occurrence of PSH after ACOP, and irregular HBO treatment after onset might be associated with the occurrence of PSH after ACOP. All three PSH patients developed paroxysmal postural or dystonic disorders after onset, accompanied by sympathetic excitation manifestations such as increased heart rate, respiratory rate, elevated blood pressure, and fever. Antiepileptic drugs had poor effects, and the attacks were effectively controlled after HBO treatment combined with adjusted drug therapy. The results indicate that for patients with severe carbon monoxide poisoning, especially those with a long coma duration or irregular HBO treatment after onset, if epileptic seizures occur during the disease course and are accompanied by sympathetic excitation manifestations, the possibility of PSH should be considered. Regular HBO treatment is of great significance for controlling the onset of symptoms.
《JOURNAL/mgres/04.03/01612956 - 202603000 - 00002/figure1/v/2025 - 06 - 28T140100Z/r/image - tiff》阵发性交感神经过度兴奋综合征（PSH）在重度颅脑损伤患者中很常见。急性一氧化碳中毒（ACOP）可能导致继发性PSH，而高压氧（HBO）是ACOP的重要治疗方法，可促进碳氧血红蛋白解离并减少ACOP的长期后遗症。为探讨急性ACOP继发PSH的危险因素及临床特征，并研究HBO治疗的疗效，对2018年1月1日至2024年12月31日首都医科大学附属北京朝阳医院高压氧科收治的中重度ACOP患者进行回顾性分析。3例患者在住院期间发生PSH，被归入PSH组，其余50例患者为非PSH组。单因素Fisher确切概率法表明，昏迷持续时间超过72小时与ACOP后PSH的发生有关，发病后HBO治疗不规律可能与ACOP后PSH的发生有关。所有3例PSH患者发病后均出现阵发性姿势或肌张力障碍，伴有心率加快、呼吸频率增加、血压升高及发热等交感神经兴奋表现。抗癫痫药物效果不佳，HBO治疗联合调整药物治疗后发作得到有效控制。结果表明，对于重度一氧化碳中毒患者，尤其是昏迷持续时间长或发病后HBO治疗不规律者，若病程中出现癫痫发作并伴有交感神经兴奋表现，应考虑PSH的可能。规律的HBO治疗对控制症状发作具有重要意义。
