高压氧治疗急性一氧化碳中毒的临床疗效研究
|
摘要
急性一氧化碳中毒是我国发病人数和死亡人数最多的急性职业中毒。一氧化碳也是许多国家引起意外生活性中毒中致死人数最多的毒物。我国常见的生活性中毒的原因为烟囱阻塞,倒烟以及门窗紧闭,室内通风不良引起一氧化碳在室内聚集,而煤气管道泄露也是常见原因之一。职业性中毒常见于煤矿瓦斯爆炸。国外常见于壁炉故障,加热源通风不足,以及吸入汽车尾气,而气象灾害常造成一氧化碳中毒的流行和爆发。但是,我国目前罕有气象条件与一氧化碳中毒方面的研究资料。目前关于一氧化碳中毒的临床研究较多,而流行病学资料较少。为进一步明确我市一氧化碳中毒的发病规律,并根据相应规律做好防护措施,从而降低一氧化碳中毒的发生。目前的治疗措施主要是:一方面尽快促使中毒者体内的碳氧血红蛋白解离,恢复正常血红蛋白的携氧和供氧功能;另一方面尽快恢复因缺氧造成的器官组织功能损伤。高压氧治疗可以迅速增加血液中的血氧含量并强制解离碳氧血红蛋白,从而迅速解除急性一氧化碳中毒患者的缺氧状态,是任何其他治疗所无法代替的,因此,高压氧对急性一氧化碳中毒是一种特效治疗。而急性一氧化碳中毒患者高压氧治疗的早晚,决定了患者高压氧治疗的疗效。
本研究采用回顾性调查方法,统计分析采用统计图表及R×C的卡方检验和秩和检验,统计分析软件是SPSS16.0。P<0.05为具有统计学差异。按照急性一氧化碳中毒发病的三间分布描述一氧化碳中毒的发病规律,分析影响高压氧治疗效果的相关因素,为一氧化碳中毒的预防控制对策提高依据。
结果表明气象条件可能是一氧化碳中毒的决定因素,而寒冷季节室内取暖时,煤炭、燃气、木柴等含碳物质的不完全燃烧产生的一氧化碳是导致生活性一氧化碳中毒的直接原因。不同年龄段中毒程度存在差异,具体而言,中老年人中、重度中毒的比例要大。男女患者中毒程度有差别,发病构成比不同,男性患者中、重度中毒的比例要比女性高,有统计学意义。急性一氧化碳中毒患者及时行高压氧治疗可以加快一氧化碳排出,纠正机体缺氧。高压氧治疗急性一氧化碳中毒具有恢复时间短、治愈率高、病死率低的优点。急性一氧化碳中毒患者治疗越早疗效越好,治愈率越高。随着患者开始高压氧治疗时间的延长,患者的治愈率明显下降,而患者的平均治疗次数明显增多,两者有显著的统计学差异。
本研究说明一氧化碳中毒的发生与气象条件、年龄、性别有关。研究易于产生一氧化碳、不利于一氧化碳扩散的气象条件,开展一氧化碳中毒气象条件预报,提高中毒伤害监测预警能力,加强气象因素与中毒伤害关系研究,开展中毒监测预警、对居民进行中毒预防健康教育、改善居住环境可以控制一氧化碳中毒的发生。发生急性一氧化碳中毒后,应尽快进行高压氧治疗,因高压氧治疗可以迅速清除体内高浓度的一氧化碳,改善机体的缺氧、组织呼吸抑制状态,从而减轻器官和组织的损伤。另外,高压氧疗效虽好,但并非能解决一切问题,而应重视综合治疗,以利取得最佳疗效。
Background: The incidence and the number of deaths of acute carbon monoxide poisoning are the most among acute occupational poisoning. Carbon monoxide is also the toxicant which cause the most deaths in the accidents of life in many countries. The life of our common cause of poisoning is blocking the chimney, and doors and windows closed down smoke, carbon monoxide caused by poor indoor ventilation in the room together, and gas leaks are also common reasons. Occupational poisoning is common in coal mine gas explosion. Foreign common in the firepla1ce failure, inadequate ventilation, heat source, and the inhalation of vehicle exhaust, and carbon monoxide poisoning caused by meteorological disasters often popular and outbreaks. Present clinical study on the more carbon monoxide poisoning, and epidemiological data less. To further define the incidence of carbon monoxide poisoning laws of the city and do a good job under the corresponding law of protective measures to reduce the incidence of carbon monoxide poisoning. Current treatment is mainly: on the one hand the body as soon as possible to promote poisoning carboxyhemoglobin dissociation and restore normal oxygen-carrying hemoglobin and oxygen function; the other hand, due to lack of oxygen to restore function of organ and tissue damage. Hyperbaric oxygen therapy can rapidly increase the blood oxygen content and dissociation of carboxyhemoglobin forced to quickly relieve patients with acute carbon monoxide poisoning, hypoxia, and no other treatment can not be replaced, therefore, hyperbaric oxygen on acute carbon monoxide poisoning a specific treatment. Of acute carbon monoxide poisoning treated with hyperbaric oxygen in patients with early or late, determines the efficacy of hyperbaric oxygen therapy patients.
Objective: To further define the incidence of poisoning CO city laws and in accordance with the appropriate protective measures to do law, thereby reducing the incidence of CO poisoning, the epidemiology of the disease on this study to make a comprehensive analysis of the description, further analysis of high-pressure oxygen treatment related factors, prevention and control of carbon monoxide poisoning as measures to improve the basis of prevention of such poisoning control measures.
Methods: A retrospective survey methods, statistical analysis using charts and R×C chi-square test and rank sum test, statistical analysis software is SPSS16.0. P <0.05 as statistically different. In accordance with the incidence of acute carbon monoxide poisoning distribution of the three rules described the incidence of carbon monoxide poisoning, hyperbaric oxygen treatment analysis of the relevant factors.
Results: The results showed that weather conditions may be determinants of carbon monoxide poisoning, and cold season, when indoor heating, coal, gas, wood and other carbonaceous materials produced by the incomplete combustion of carbon monoxide is the leading life, the direct cause of carbon monoxide poisoning. Different ages are different degrees of poisoning, in particular, the elderly, the proportion of severe poisoning is bigger. Differences between male and female patients the degree of intoxication, the incidence of different composition than the male patients, the proportion of severe poisoning than females, was statistically significant. Time-line in patients with acute carbon monoxide poisoning treated with hyperbaric oxygen can speed up the discharge of carbon monoxide to correct hypoxia. Hyperbaric oxygen for acute carbon monoxide poisoning with recovery time is short, high cure rate, low mortality advantages. Patients with acute carbon monoxide poisoning effect sooner the better, the cure rate is higher. Start with hyperbaric oxygen therapy in patients with time, the cure rate of patients decreased, while the average number of treatment of patients increased significantly, both statistically significant difference.
Conclusion: This study shows the incidence of carbon monoxide poisoning and meteorological conditions, age and gender. Research prone to carbon monoxide, carbon monoxide is not conducive to the spread of weather conditions, forecast weather conditions to carry out carbon monoxide poisoning and improve monitoring and early warning capacity poisoning injuries, poisoning, injury to strengthen relations between meteorological factors and research, carry out monitoring and early warning poisoning, poisoning the residents carry out preventive health education, improving living environment can control the occurrence of carbon monoxide poisoning. After acute carbon monoxide poisoning, hyperbaric oxygen treatment should be as soon as possible, due to hyperbaric oxygen therapy can be quickly rid the body of a high concentration of carbon monoxide, improve the body's oxygen, tissue respiratory depression status, so as to reduce damage to organs and tissues. In addition, the efficacy of hyperbaric oxygen is good, but can not solve every problem, but should pay attention to comprehensive treatment, to facilitate the best results.
本研究采用回顾性调查方法,统计分析采用统计图表及R×C的卡方检验和秩和检验,统计分析软件是SPSS16.0。P<0.05为具有统计学差异。按照急性一氧化碳中毒发病的三间分布描述一氧化碳中毒的发病规律,分析影响高压氧治疗效果的相关因素,为一氧化碳中毒的预防控制对策提高依据。
结果表明气象条件可能是一氧化碳中毒的决定因素,而寒冷季节室内取暖时,煤炭、燃气、木柴等含碳物质的不完全燃烧产生的一氧化碳是导致生活性一氧化碳中毒的直接原因。不同年龄段中毒程度存在差异,具体而言,中老年人中、重度中毒的比例要大。男女患者中毒程度有差别,发病构成比不同,男性患者中、重度中毒的比例要比女性高,有统计学意义。急性一氧化碳中毒患者及时行高压氧治疗可以加快一氧化碳排出,纠正机体缺氧。高压氧治疗急性一氧化碳中毒具有恢复时间短、治愈率高、病死率低的优点。急性一氧化碳中毒患者治疗越早疗效越好,治愈率越高。随着患者开始高压氧治疗时间的延长,患者的治愈率明显下降,而患者的平均治疗次数明显增多,两者有显著的统计学差异。
本研究说明一氧化碳中毒的发生与气象条件、年龄、性别有关。研究易于产生一氧化碳、不利于一氧化碳扩散的气象条件,开展一氧化碳中毒气象条件预报,提高中毒伤害监测预警能力,加强气象因素与中毒伤害关系研究,开展中毒监测预警、对居民进行中毒预防健康教育、改善居住环境可以控制一氧化碳中毒的发生。发生急性一氧化碳中毒后,应尽快进行高压氧治疗,因高压氧治疗可以迅速清除体内高浓度的一氧化碳,改善机体的缺氧、组织呼吸抑制状态,从而减轻器官和组织的损伤。另外,高压氧疗效虽好,但并非能解决一切问题,而应重视综合治疗,以利取得最佳疗效。
Background: The incidence and the number of deaths of acute carbon monoxide poisoning are the most among acute occupational poisoning. Carbon monoxide is also the toxicant which cause the most deaths in the accidents of life in many countries. The life of our common cause of poisoning is blocking the chimney, and doors and windows closed down smoke, carbon monoxide caused by poor indoor ventilation in the room together, and gas leaks are also common reasons. Occupational poisoning is common in coal mine gas explosion. Foreign common in the firepla1ce failure, inadequate ventilation, heat source, and the inhalation of vehicle exhaust, and carbon monoxide poisoning caused by meteorological disasters often popular and outbreaks. Present clinical study on the more carbon monoxide poisoning, and epidemiological data less. To further define the incidence of carbon monoxide poisoning laws of the city and do a good job under the corresponding law of protective measures to reduce the incidence of carbon monoxide poisoning. Current treatment is mainly: on the one hand the body as soon as possible to promote poisoning carboxyhemoglobin dissociation and restore normal oxygen-carrying hemoglobin and oxygen function; the other hand, due to lack of oxygen to restore function of organ and tissue damage. Hyperbaric oxygen therapy can rapidly increase the blood oxygen content and dissociation of carboxyhemoglobin forced to quickly relieve patients with acute carbon monoxide poisoning, hypoxia, and no other treatment can not be replaced, therefore, hyperbaric oxygen on acute carbon monoxide poisoning a specific treatment. Of acute carbon monoxide poisoning treated with hyperbaric oxygen in patients with early or late, determines the efficacy of hyperbaric oxygen therapy patients.
Objective: To further define the incidence of poisoning CO city laws and in accordance with the appropriate protective measures to do law, thereby reducing the incidence of CO poisoning, the epidemiology of the disease on this study to make a comprehensive analysis of the description, further analysis of high-pressure oxygen treatment related factors, prevention and control of carbon monoxide poisoning as measures to improve the basis of prevention of such poisoning control measures.
Methods: A retrospective survey methods, statistical analysis using charts and R×C chi-square test and rank sum test, statistical analysis software is SPSS16.0. P <0.05 as statistically different. In accordance with the incidence of acute carbon monoxide poisoning distribution of the three rules described the incidence of carbon monoxide poisoning, hyperbaric oxygen treatment analysis of the relevant factors.
Results: The results showed that weather conditions may be determinants of carbon monoxide poisoning, and cold season, when indoor heating, coal, gas, wood and other carbonaceous materials produced by the incomplete combustion of carbon monoxide is the leading life, the direct cause of carbon monoxide poisoning. Different ages are different degrees of poisoning, in particular, the elderly, the proportion of severe poisoning is bigger. Differences between male and female patients the degree of intoxication, the incidence of different composition than the male patients, the proportion of severe poisoning than females, was statistically significant. Time-line in patients with acute carbon monoxide poisoning treated with hyperbaric oxygen can speed up the discharge of carbon monoxide to correct hypoxia. Hyperbaric oxygen for acute carbon monoxide poisoning with recovery time is short, high cure rate, low mortality advantages. Patients with acute carbon monoxide poisoning effect sooner the better, the cure rate is higher. Start with hyperbaric oxygen therapy in patients with time, the cure rate of patients decreased, while the average number of treatment of patients increased significantly, both statistically significant difference.
Conclusion: This study shows the incidence of carbon monoxide poisoning and meteorological conditions, age and gender. Research prone to carbon monoxide, carbon monoxide is not conducive to the spread of weather conditions, forecast weather conditions to carry out carbon monoxide poisoning and improve monitoring and early warning capacity poisoning injuries, poisoning, injury to strengthen relations between meteorological factors and research, carry out monitoring and early warning poisoning, poisoning the residents carry out preventive health education, improving living environment can control the occurrence of carbon monoxide poisoning. After acute carbon monoxide poisoning, hyperbaric oxygen treatment should be as soon as possible, due to hyperbaric oxygen therapy can be quickly rid the body of a high concentration of carbon monoxide, improve the body's oxygen, tissue respiratory depression status, so as to reduce damage to organs and tissues. In addition, the efficacy of hyperbaric oxygen is good, but can not solve every problem, but should pay attention to comprehensive treatment, to facilitate the best results.
引文
[1] Simpson A. Compressed air as a therapeutic agent in the treatment of consumption, asthma, chronic bronchitis and other diseases [J]. Edinburgh: Sutherland and Knox, 1857.
[2] Kindwall EP, editor. Hyperbaric medicine practice[M]. Flagstaff, AZ: Best Publishing Company, 1995.
[3] H.E. Le Grand. Lavoisier's oxygen theory of acidity[J]. Annals of Science, 1972 , 29(1):1– 18.
[4] Fontaine JA. Emploi chirurgical de l’air comprime[J]. Union Med 1879; 28:445.
[5] Corning JL. The use of compressed air in conjunction with medical solutions in the treatment of nervous and mental affections, being a new system of cerebrospinal therapeutics[J]. Med Record 1891; 40: 225.
[6] Jain KK. Textbook of hyperbaric medicine[M]. Toronto: Hogrefe & Huber, 1990.
[7] Cunningham OJ. Oxygen therapy by means of compressed air[J]. Anesth Anal 1927; 6: 64.
[8] American Medical Association Bureau of Investigation. The Cunningham“tank treatment”. The alleged value of compressed air in the treatment of diabetes mellitus, pernicious anaemia and carcinoma[J]. JAMA 1928; 90: 1494-1496.
[9] Churchill-Davidson I, Sanger C, Thomlinson RH. High-pressure oxygen and radiotherapy[J]. Lancet 1955; 1: 1091-1095.
[10] Boerema I, Knoll JA, Meijne NG, et al. High atmospheric pressure as an aid to cardiac surgery[J]. Arch Chir Neerl 1956; 8: 193-211.
[11] Brummelkamp WH, Hogenijk J, Boerema I. Treatment of anaerobic infections (clostridial myositis) by drenching the tissue with oxygen under high atmospheric pressure[J]. Surgery 1961; 49: 299-302.
[12] Smith G, Sharp GR. Treatment of coal gas poisoning with oxygen at two atmospheres pressure[J]. Lancet 1962; 1: 816-819.
[13] ZALOSH R G. Hydrogen flammability and ignotability in deep diving atmospheres[A]. In: Ralph W. Hydrogen as a diving gas[C]. Bethesda, Maryland, 1987. 213 225.
[14]龚锦涵.加压舱内火灾事故一起调查分析[J].海军军事医学,1979,1(1):15-21.
[15]谢金祥.日常外用药物及化妆品在高压氧舱内自燃可能性的研究[J].中华航海医学杂志,1999,6(1):35-37.
[16]龚锦涵.高压氧治疗中的火灾问题[J].海军医学,1988,6(2):47-50.
[17] Cobb N, Etzel R. Unintentional carbon monoxide-related deaths in The United States,1979 through 1988[J]. JAMA 1991;266:659-63
[18] Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease[J]. Undersea Hyperb Med 2007; 34:163-8.
[19] Louise WK, Kristine AN.Carbon Monoxide Poisoning[J]. Med Clin N Am 89 (2005) 1161–1194.
[20]Lindell KW. Carbon Monoxide Poisoning[J]. N Engl J Med 2009;360:1217-25.
[21]刘晓燕.临床脑电图学[M].北京:人民卫生出版社,2006:5.
[22]杨小芳,聂本刚,黄素蓉.脑电图在一氧化碳中毒后迟发性脑病中的作用[J].华西医学,2005,20(4):665-666.
[23] Sverre W, David L, Ingmar R. Carbon Monoxide Poisoning[J]. Acta Paediatrica 2008; 97: pp. 915–919.
[24]柳宇祥.一氧化碳中毒性脑病60例CT、MRI及预后分析[J].中国社区医师,2009(23):157.
[25]顾仁骏,卢红.急性一氧化碳中毒后迟发性脑病患者脑脊液免疫球蛋白和肿瘤坏死因子—α水平的变化[J].中风与神经疾病杂志,2001,18:173-174.
[26]韩宁,李勇,陈卫民.急性一氧化碳中毒患者血生化相关指标的变化[J].世界华人消化杂志2009; 17(1): 74-77.
[27]庞继恩,高先凯,刘松,等.心脏肌钙蛋白Ⅰ对急性CO中毒心肌损伤诊断价值的探讨[J].中国现代医学杂志,2002,12(6):95-97.
[28]毛鹏琪,张新,张敏,等.98例急性一氧化碳中毒心电图分析[J].实用医技杂志,2004,11 (4):446.
[29] Jeffrey C, FACEP and Marc R. CARBON MONOXIDE POISONING DURING NATURAL DISASTERS:THE HURRICANE RITA EXPERIENCE[J]. The Journal of Emergency Medicine, 2007,33:261–264.
[30]中华人民共和国卫生部GBZ 23-2002.职业性急性一氧化碳中毒诊断标准. 2002.
[31]牛凤云,郭艾萍,郑小英,等.急性一氧化碳中毒312例临床分析[J].中华全科医师杂志, 2005, 11∶661 - 662.
[32]纪明毅,冯梅秀,刘莹莹.急性一氧化碳中毒患者高压氧急救治疗的时效性[J].海南医学,2009;20(5):180-182.
[33]高水萍,张秀丽,张彩红.高压氧综合治疗急性一氧化碳中毒155例疗效观察[J].实用医技杂志,2008;15 (30):4236-4237.
[34]杨立明,任引竹.急性一氧化碳中毒469例流行病学调查[J].中国误诊学杂志, 2005, 5: 2969 - 2970.
[35]杨金玲,丁锡强,高峰.非职业性一氧化碳中毒的气象条件分析[J].现代农业科技,2008 ,17 :320-321
[36]李良辉,胡冰.宜春地区一氧化碳中毒病人的流行病学调查与预防对策研究[ J ].中华流行病学杂志,2000, 21: 368.
[37]方四新,张俊青,胡明霞等.家庭一氧化碳中毒事件聚集性暴发的流行病学调查[J].安徽预防医学杂志,2007,13(3):171-173
[38]周静,陈曙扬,李中杰,等. 25所综合医院急诊科化学品中毒调查[J].中华急诊医学杂志, 2004, 13 (11) : 730.
[39]杨功焕,马杰民,刘娜,等.中国人群2002年吸烟和被动吸烟的现状调查[J ].中华流行病学杂志, 2005, 26 (2) : 79.
[40] Ernst A, Zibrak JD. Carbon monoxide poisoning[J]. N Engl J Med 1998;339:1603-8.
[41] Amitai Y, Zlotogorski Z, Golan-KatzavV, et al.Neuro-psychological impairment from acute low-level exposure to carbon monoxide[J]. Arch Neurol 1998;55:845-8.
[42] Boehning D, Moon C, Sharma S, et al.Carbon monoxide neurotransmission activated by CK2 phosphorylation of heme oxygenase-2[J]. Neuron 2003;40:129-37.
[43] Mannaioni PF, Vannacci A, Masini E.Carbon monoxide: the bad and the good side of the coin, from neuronal death to anti-inflammatory activity[J]. Inflamm Res 2006;55:261-73.
[44] Zhang X, Shan P, Otterbein LE, et al.Carbon monoxide inhibition of apoptosis during ischemia-reperfusion lung injury is dependent on the p38 mitogenactivatedprotein kinase pathway andinvolves caspase 3[J]. J Biol Chem 2003;278:1248-58.
[45] TailléC, Almolki A, Benhamed M, et al. Heme oxygenase inhibits human airway smooth muscle proliferation via a bilirubin dependent modulation of ERK1/2 phosphorylation[J]. J Biol Chem 2003;278:27160-8.
[46]陆再英,钟南山主编.内科学[M].北京:人民卫生出版社,2008,935-938.
[47]高春锦等.急性一氧化碳中毒.高压氧医学基础与临床[M].北京:人民卫生出版社,2008,239-260.
[48]丁建章周正谋牛建刚等.高压氧对毛细血管壁通透性的影响[J].微循环技术杂志,1996,3:124-125.
[49]李雁周琳瑛姚祖武等.高压氧对大鼠血管内皮损伤超微结构及血浆内皮素-1浓度的影响[J].中华航海医学与高气压医学杂志,2003,10:165-168.
[50]顾黎明.高压氧治疗对急性脑梗塞患者肾功能变化的影响76例观察[J].中华新医学,2004,5(3):210-211.
[51] Lindell K. Weaver, M.D. Carbon Monoxide Poisoning[J]. N Engl J Med 2009;360 :1217-25
[52] Geehr EC, Salluzzo R, Bosco S, et al.Emergency health impact of a severe storm[J]. Am J Emerg Med 1989;7:598–604.
[53] Wrenn K, Connors GP. Carbon monoxide poisoning during ice storms: a tale of two cities[J]. J Emerg Med 1997;15:465–7.
[54] Houck PM, Hampson NB. Epidemic carbon monoxide poisoning following a winter storm[J]. J Emerg Med 1997;15:469–73.
[55] Centers for Disease Control and Prevention. Carbon monoxide poisonings associated with snow-obstructed vehicle exhaust systems—Philadelphia and New York City, January 1996[J]. MMWR1996;45:1–3.
[56] Hartling L, Brison RJ, Pickett W. Cluster of unintentional carbon monoxide poisonings presenting to the emergency departments inKingston, Ontario during“Ice Storm 98”[J]. Can J Public Health 1998;89:388–90.
[57] Daley WR, Smith A, Paz-Argandona E, Malilay J, McGeehin M. An outbreak of carbon monoxide poisoning after a major ice storm in Maine[J]. J Emerg Med 2000:18:87–93.
[58] Cohen BA, Stolp BW, Dear BD, Moon RE, Frazier LM. Carbon monoxide poisoning in the aftermath of Hurricane Fran [letter].Am J PublicHealth1999;89:112.
[59]Centers for Disease Control and Prevention. Deaths associated with Hurricane Georges—Puerto Rico, September 1998[J]. MMWR1998;47:897–8.
[60]Centers for Disease Control and Prevention. Morbidity and mortality associated with Hurricane Floyd—North Carolina, September-October 1999[J]. MMWR 2000;49:369–72.
[61]W. Randolph D, Larry S, and Rod G.A . FLOOD-RELATED OUTBREAK OF CARBON MONOXIDE POISONING—GRAND FORKS, NORTH DAKOTA[J] .The Journal of Emergency Medicine, 2001,21:249–253,
[62]Jeffrey C, FACEP and Marc R. CARBON MONOXIDE POISONING DURING NATURAL DISASTERS:THE HURRICANE RITA EXPERIENCE[J]. The Journal of Emergency Medicine, 2007,33:261–264.
[63] W. Randolph D, Andrew S, Enrique P,et al.AN OUTBREAK OF CARBON MONOXIDE POISONING AFTER A MAJOR ICE STORM IN MAINE[J]. The Journal of Emergency Medicine, 2000,18:87–93.
[65]王晓明,孙力,刘海峰,等.一次大范围一氧化碳中毒事件的气象条件[J].气象,2007,33(2):102-106.
[65]路屹雄,王元.一次高影响天气事件-延边2.13一氧化碳中毒事件分析[J].南京大学学报,2008,44(3):259-272.
[66]李明香,何晓东,郭兆丽,等.营口市一氧化碳中毒事件发生日气象条件分析[J].气象与环境学报,2007,23(4):25-28.
[2] Kindwall EP, editor. Hyperbaric medicine practice[M]. Flagstaff, AZ: Best Publishing Company, 1995.
[3] H.E. Le Grand. Lavoisier's oxygen theory of acidity[J]. Annals of Science, 1972 , 29(1):1– 18.
[4] Fontaine JA. Emploi chirurgical de l’air comprime[J]. Union Med 1879; 28:445.
[5] Corning JL. The use of compressed air in conjunction with medical solutions in the treatment of nervous and mental affections, being a new system of cerebrospinal therapeutics[J]. Med Record 1891; 40: 225.
[6] Jain KK. Textbook of hyperbaric medicine[M]. Toronto: Hogrefe & Huber, 1990.
[7] Cunningham OJ. Oxygen therapy by means of compressed air[J]. Anesth Anal 1927; 6: 64.
[8] American Medical Association Bureau of Investigation. The Cunningham“tank treatment”. The alleged value of compressed air in the treatment of diabetes mellitus, pernicious anaemia and carcinoma[J]. JAMA 1928; 90: 1494-1496.
[9] Churchill-Davidson I, Sanger C, Thomlinson RH. High-pressure oxygen and radiotherapy[J]. Lancet 1955; 1: 1091-1095.
[10] Boerema I, Knoll JA, Meijne NG, et al. High atmospheric pressure as an aid to cardiac surgery[J]. Arch Chir Neerl 1956; 8: 193-211.
[11] Brummelkamp WH, Hogenijk J, Boerema I. Treatment of anaerobic infections (clostridial myositis) by drenching the tissue with oxygen under high atmospheric pressure[J]. Surgery 1961; 49: 299-302.
[12] Smith G, Sharp GR. Treatment of coal gas poisoning with oxygen at two atmospheres pressure[J]. Lancet 1962; 1: 816-819.
[13] ZALOSH R G. Hydrogen flammability and ignotability in deep diving atmospheres[A]. In: Ralph W. Hydrogen as a diving gas[C]. Bethesda, Maryland, 1987. 213 225.
[14]龚锦涵.加压舱内火灾事故一起调查分析[J].海军军事医学,1979,1(1):15-21.
[15]谢金祥.日常外用药物及化妆品在高压氧舱内自燃可能性的研究[J].中华航海医学杂志,1999,6(1):35-37.
[16]龚锦涵.高压氧治疗中的火灾问题[J].海军医学,1988,6(2):47-50.
[17] Cobb N, Etzel R. Unintentional carbon monoxide-related deaths in The United States,1979 through 1988[J]. JAMA 1991;266:659-63
[18] Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease[J]. Undersea Hyperb Med 2007; 34:163-8.
[19] Louise WK, Kristine AN.Carbon Monoxide Poisoning[J]. Med Clin N Am 89 (2005) 1161–1194.
[20]Lindell KW. Carbon Monoxide Poisoning[J]. N Engl J Med 2009;360:1217-25.
[21]刘晓燕.临床脑电图学[M].北京:人民卫生出版社,2006:5.
[22]杨小芳,聂本刚,黄素蓉.脑电图在一氧化碳中毒后迟发性脑病中的作用[J].华西医学,2005,20(4):665-666.
[23] Sverre W, David L, Ingmar R. Carbon Monoxide Poisoning[J]. Acta Paediatrica 2008; 97: pp. 915–919.
[24]柳宇祥.一氧化碳中毒性脑病60例CT、MRI及预后分析[J].中国社区医师,2009(23):157.
[25]顾仁骏,卢红.急性一氧化碳中毒后迟发性脑病患者脑脊液免疫球蛋白和肿瘤坏死因子—α水平的变化[J].中风与神经疾病杂志,2001,18:173-174.
[26]韩宁,李勇,陈卫民.急性一氧化碳中毒患者血生化相关指标的变化[J].世界华人消化杂志2009; 17(1): 74-77.
[27]庞继恩,高先凯,刘松,等.心脏肌钙蛋白Ⅰ对急性CO中毒心肌损伤诊断价值的探讨[J].中国现代医学杂志,2002,12(6):95-97.
[28]毛鹏琪,张新,张敏,等.98例急性一氧化碳中毒心电图分析[J].实用医技杂志,2004,11 (4):446.
[29] Jeffrey C, FACEP and Marc R. CARBON MONOXIDE POISONING DURING NATURAL DISASTERS:THE HURRICANE RITA EXPERIENCE[J]. The Journal of Emergency Medicine, 2007,33:261–264.
[30]中华人民共和国卫生部GBZ 23-2002.职业性急性一氧化碳中毒诊断标准. 2002.
[31]牛凤云,郭艾萍,郑小英,等.急性一氧化碳中毒312例临床分析[J].中华全科医师杂志, 2005, 11∶661 - 662.
[32]纪明毅,冯梅秀,刘莹莹.急性一氧化碳中毒患者高压氧急救治疗的时效性[J].海南医学,2009;20(5):180-182.
[33]高水萍,张秀丽,张彩红.高压氧综合治疗急性一氧化碳中毒155例疗效观察[J].实用医技杂志,2008;15 (30):4236-4237.
[34]杨立明,任引竹.急性一氧化碳中毒469例流行病学调查[J].中国误诊学杂志, 2005, 5: 2969 - 2970.
[35]杨金玲,丁锡强,高峰.非职业性一氧化碳中毒的气象条件分析[J].现代农业科技,2008 ,17 :320-321
[36]李良辉,胡冰.宜春地区一氧化碳中毒病人的流行病学调查与预防对策研究[ J ].中华流行病学杂志,2000, 21: 368.
[37]方四新,张俊青,胡明霞等.家庭一氧化碳中毒事件聚集性暴发的流行病学调查[J].安徽预防医学杂志,2007,13(3):171-173
[38]周静,陈曙扬,李中杰,等. 25所综合医院急诊科化学品中毒调查[J].中华急诊医学杂志, 2004, 13 (11) : 730.
[39]杨功焕,马杰民,刘娜,等.中国人群2002年吸烟和被动吸烟的现状调查[J ].中华流行病学杂志, 2005, 26 (2) : 79.
[40] Ernst A, Zibrak JD. Carbon monoxide poisoning[J]. N Engl J Med 1998;339:1603-8.
[41] Amitai Y, Zlotogorski Z, Golan-KatzavV, et al.Neuro-psychological impairment from acute low-level exposure to carbon monoxide[J]. Arch Neurol 1998;55:845-8.
[42] Boehning D, Moon C, Sharma S, et al.Carbon monoxide neurotransmission activated by CK2 phosphorylation of heme oxygenase-2[J]. Neuron 2003;40:129-37.
[43] Mannaioni PF, Vannacci A, Masini E.Carbon monoxide: the bad and the good side of the coin, from neuronal death to anti-inflammatory activity[J]. Inflamm Res 2006;55:261-73.
[44] Zhang X, Shan P, Otterbein LE, et al.Carbon monoxide inhibition of apoptosis during ischemia-reperfusion lung injury is dependent on the p38 mitogenactivatedprotein kinase pathway andinvolves caspase 3[J]. J Biol Chem 2003;278:1248-58.
[45] TailléC, Almolki A, Benhamed M, et al. Heme oxygenase inhibits human airway smooth muscle proliferation via a bilirubin dependent modulation of ERK1/2 phosphorylation[J]. J Biol Chem 2003;278:27160-8.
[46]陆再英,钟南山主编.内科学[M].北京:人民卫生出版社,2008,935-938.
[47]高春锦等.急性一氧化碳中毒.高压氧医学基础与临床[M].北京:人民卫生出版社,2008,239-260.
[48]丁建章周正谋牛建刚等.高压氧对毛细血管壁通透性的影响[J].微循环技术杂志,1996,3:124-125.
[49]李雁周琳瑛姚祖武等.高压氧对大鼠血管内皮损伤超微结构及血浆内皮素-1浓度的影响[J].中华航海医学与高气压医学杂志,2003,10:165-168.
[50]顾黎明.高压氧治疗对急性脑梗塞患者肾功能变化的影响76例观察[J].中华新医学,2004,5(3):210-211.
[51] Lindell K. Weaver, M.D. Carbon Monoxide Poisoning[J]. N Engl J Med 2009;360 :1217-25
[52] Geehr EC, Salluzzo R, Bosco S, et al.Emergency health impact of a severe storm[J]. Am J Emerg Med 1989;7:598–604.
[53] Wrenn K, Connors GP. Carbon monoxide poisoning during ice storms: a tale of two cities[J]. J Emerg Med 1997;15:465–7.
[54] Houck PM, Hampson NB. Epidemic carbon monoxide poisoning following a winter storm[J]. J Emerg Med 1997;15:469–73.
[55] Centers for Disease Control and Prevention. Carbon monoxide poisonings associated with snow-obstructed vehicle exhaust systems—Philadelphia and New York City, January 1996[J]. MMWR1996;45:1–3.
[56] Hartling L, Brison RJ, Pickett W. Cluster of unintentional carbon monoxide poisonings presenting to the emergency departments inKingston, Ontario during“Ice Storm 98”[J]. Can J Public Health 1998;89:388–90.
[57] Daley WR, Smith A, Paz-Argandona E, Malilay J, McGeehin M. An outbreak of carbon monoxide poisoning after a major ice storm in Maine[J]. J Emerg Med 2000:18:87–93.
[58] Cohen BA, Stolp BW, Dear BD, Moon RE, Frazier LM. Carbon monoxide poisoning in the aftermath of Hurricane Fran [letter].Am J PublicHealth1999;89:112.
[59]Centers for Disease Control and Prevention. Deaths associated with Hurricane Georges—Puerto Rico, September 1998[J]. MMWR1998;47:897–8.
[60]Centers for Disease Control and Prevention. Morbidity and mortality associated with Hurricane Floyd—North Carolina, September-October 1999[J]. MMWR 2000;49:369–72.
[61]W. Randolph D, Larry S, and Rod G.A . FLOOD-RELATED OUTBREAK OF CARBON MONOXIDE POISONING—GRAND FORKS, NORTH DAKOTA[J] .The Journal of Emergency Medicine, 2001,21:249–253,
[62]Jeffrey C, FACEP and Marc R. CARBON MONOXIDE POISONING DURING NATURAL DISASTERS:THE HURRICANE RITA EXPERIENCE[J]. The Journal of Emergency Medicine, 2007,33:261–264.
[63] W. Randolph D, Andrew S, Enrique P,et al.AN OUTBREAK OF CARBON MONOXIDE POISONING AFTER A MAJOR ICE STORM IN MAINE[J]. The Journal of Emergency Medicine, 2000,18:87–93.
[65]王晓明,孙力,刘海峰,等.一次大范围一氧化碳中毒事件的气象条件[J].气象,2007,33(2):102-106.
[65]路屹雄,王元.一次高影响天气事件-延边2.13一氧化碳中毒事件分析[J].南京大学学报,2008,44(3):259-272.
[66]李明香,何晓东,郭兆丽,等.营口市一氧化碳中毒事件发生日气象条件分析[J].气象与环境学报,2007,23(4):25-28.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |