Hsu L H, Wang J H
Department of Respiratory Therapy, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Dec;58(6):407-13.
Carbon monoxide poisoning is a major cause of accidental morbidity and mortality in Taiwan. Utilization of hyperbaric oxygen in severely carbon monoxide intoxicated patients has been investigated widely. The object of this study was to determine the nature of carbon monoxide poisoning and to evaluate the effect of hyperbaric oxygen therapy for such patients.
Retrospective analysis of 34 consecutive carbon monoxide intoxicated patients by review of medical records and clinical follow-up for the past three years.
Subjects were 10 males and 24 females, aged 12 to 82 years. The source of the poisoning in 25 cases was faulty-operating heating systems; in 4, incomplete combustion of automobile engine; in 3, use of alternative sources of energy for indoor cooking and heating; in 2, smoke inhalation in fire accidents. All had neurologic symptoms; five also had cardiovascular symptoms and one developed delayed neurologic sequelae. The group with poor outcome after hyperbaric oxygen therapy (n = 10) had higher serum CK values, lower Glasgow coma scale, longer delay in the first aid at emergency service and longer delay in provision of hyperbaric oxygen therapy.
It was concluded that hyperbaric oxygen therapy is an effective method in treating carbon monoxide intoxicated patients. Understanding the pathogenesis of carbon monoxide poisoning and indications for hyperbaric oxygen therapy will help physicians manage such patients earlier and more adequately. Information on currently available hyperbaric facilities in Taiwan is necessary for timely transfer.
一氧化碳中毒是台湾意外发病和死亡的主要原因。高压氧在重度一氧化碳中毒患者中的应用已得到广泛研究。本研究的目的是确定一氧化碳中毒的性质，并评估高压氧治疗此类患者的效果。
通过回顾过去三年的病历和临床随访，对34例连续的一氧化碳中毒患者进行回顾性分析。
受试者包括10名男性和24名女性，年龄在12至82岁之间。25例中毒的来源是加热系统操作故障；4例是汽车发动机不完全燃烧；3例是使用替代能源进行室内烹饪和取暖；2例是火灾事故中吸入烟雾。所有患者均有神经症状；5例还有心血管症状，1例出现迟发性神经后遗症。高压氧治疗后预后较差的组（n = 10）血清肌酸激酶值较高，格拉斯哥昏迷量表评分较低，急诊急救延迟时间较长，高压氧治疗延迟时间较长。
得出结论，高压氧治疗是治疗一氧化碳中毒患者的有效方法。了解一氧化碳中毒的发病机制和高压氧治疗的适应症将有助于医生更早、更充分地管理此类患者。及时转运需要台湾目前可用高压氧设施的信息。
