摘要
本文对2023年2月1例因工厂操作失误导致硫酸二甲酯化学泄漏、随后发展为重度急性呼吸窘迫综合征(ARDS)患者的救治过程进行分析,探讨体外膜肺氧合(ECMO)在患者救治中的应用效果。患者在化学物质泄漏后5 h出现严重呼吸道症状,收治后先后接受经鼻高流量氧疗和有创机械通气治疗。在氧合指数(PaO_(2)/FiO_(2))降至100 mmHg以下时,采用静脉-静脉(VV)模式的ECMO并结合每日12 h俯卧位通气治疗,以改善氧合和肺部顺应性,经治疗患者痊愈出院。对于硫酸二甲酯中毒并发重度ARDS患者,早期实施VV-ECMO可以明显改善救治效果及预后。
This paper analyzes the treatment process of a patient who developed severe acute respiratory distress syndrome(ARDS)following a chemical leak of dimethyl sulfate caused by factory operational error in February 2023,and explores the efficacy of extracorporeal membrane oxygenation(ECMO)in patient management.The patient developed severe respiratory symptoms five hours after chemical exposure and received sequential treatment with nasal high-flow oxygen therapy and invasive mechanical ventilation upon admission.When the oxygenation index dropped below 100 mmHg,veno-venous(VV)ECMO was initiated alongside 12-hour daily prone position ventilation to improve oxygenation and lung compliance.The patient recovered and was discharged following treatment.For patients with dimethyl sulfate poisoning complicated by severe ARDS,early implementation of VV-ECMO significantly improves treatment outcomes and prognosis.
作者
张冬泉
仝茂林
袁媛
郭龙飞
Zhang Dongquan;Tong Maolin;Yuan Yuan;Guo Longfei(Department of Intensive Care Unit,Gansu Provincial Hospital,Lanzhou 73000,China;The First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou 73000,China)
出处
《中华劳动卫生职业病杂志》
北大核心
2025年第11期862-864,共3页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
甘肃省科技计划项目(21JR1RA029)
甘肃省科技计划项目(22JR11RA266)
甘肃省人民医院院内科研基金项目(21GSSYB-42)
基础研究计划-省青年科技基金(22JR11RA250)。
关键词
硫酸二甲酯
中毒
重度急性呼吸窘迫综合征
体外膜肺氧合
Dimethyl sulfate
Poisoning
Acute severe respiratory distress syndrome
Extracorporeal membrane oxygenation
