摘要目的:探讨急诊集束化联合高压氧治疗对一氧化碳（CO）中毒患者的临床疗效，并分析其预后危险因素。方法:回顾性选取2015年2月至2020年5月在临沂市中心医院急诊科进行治疗的116例CO中毒患者，按照治疗方法的不同分为对照组和治疗组，每组58例。对照组实施高压氧治疗，治疗组在对照组治疗的基础上采用急诊集束化治疗，观察并比较2组患者的临床疗效。结果:治疗组患者的治疗总有效率（93.10%）明显高于对照组（77.59%），差异有统计学意义（ P<0.05）；治疗前2组患者的呼吸频率（RR）、动脉血氧分压（PaO 2）、血氧饱和度（SaO 2）比较差异无统计学意义（ P>0.05）；与治疗前比较，2组患者治疗后RR、PaO 2、SaO 2均有改善，且治疗组优于对照组，差异均有统计学意义（ P<0.05或 P<0.01）。2组患者的昏迷时间（≥24 h）、脑电图异常、高压氧治疗时机（≥7 d）、头颅CT异常、CO暴露时间（≥3 h）是影响CO中毒预后的主要因素（ P<0.01）。昏迷时间、高压氧治疗时间、头颅CT异常是影响CO中毒预后的危险因素（ P<0.05或 P<0.01）。 结论:急诊集束化联合高压氧治疗对CO中毒患者的临床疗效较好，能有效改善患者的SaO 2及PaO 2。昏迷时间、高压氧治疗时间、头颅CT异常是影响CO中毒预后的危险因素。

abstractsObjective:To investigate the clinical efficacy of emergency bundle combined with hyperbaric oxygen therapy for patients with carbon monoxide poisoning and to analyze prognostic risk factors.Methods:A total of 116 patients with carbon monoxide poisoning treated in Linyi Central hospital from February 2015 to May 2020 were selected retrospectively and divided into control group and treatment group according to different treatment methods，with 58 cases in each group. The control group was treated with hyperbaric oxygen，and the treatment group was treated with emergency bundle on the basis of the treatment of the control group. The clinical efficacy of the two groups were observed and compared.Results:The total effective rate of the treatment group（93.10%）was significantly higher than that of the control group（77.59%），and the difference was statistically significant（ P<0.05）. There was no significant difference in respiratory rate（RR），arterial partial pressure of oxygen（PaO 2），and blood oxygen saturation（SaO 2）between two groups before treatment（ P > 0.05）. After treatment，the respiratory rate（RR），arterial partial pressure of oxygen（PaO 2），and blood oxygen saturation（SaO 2）were improved in two groups compared with those before treatment，and the treatment group was better than the control group，with statistical significance（ P < 0.05 or P < 0.01）. The coma time（≧24 h），abnormal EEG，hyperbaric oxygen treatment time（≧7 d），abnormal head CT and CO exposure time（≧3 h）in two groups were the main factors affecting the prognosis of CO poisoning（ P < 0.01）. Furthermore，coma time，hyperbaric oxygen treatment time，and abnormal head CT were the risk factors affecting the prognosis of CO poisoning（ P < 0.05 or P < 0.01）. Conclusion:Emergency bundle combined with hyperbaric oxygen therapy has a good clinical effect on patients with carbon monoxide poisoning. It can effectively improve the SaO 2 and PaO 2 of patients. The coma time，hyperbaric oxygen treatment time，and abnormal head CT were the risk factors affecting the prognosis of CO poisoning.