本研究的限制有以下：（1）本研究為回溯性病例對照研究，因此在收集資 料時仍會有受限於病歷完整性偏差；（2）因為高壓氧治療的適應症在這些病人並 沒有一定準則跟標準，所以我們並不能因此研究結果做出高壓氧治療無法預防神 經學後遺症的結論；（3）我們沒有將腦神經學影像檢查的結果納入此研究（如磁 振造影、電腦斷層等），因此無法得知影像檢查結果能否預測神經學後遺症；（4）
我們沒有對神經學後遺症做嚴重度分類．但是因為此研究主旨是要研究「有無神 經學後遺症」，神經學後遺症的嚴重度已經超出此研究範圍，但後續我們可以進 行進一步的研究來釐清此議題；（5）此研究雖然是一個大型醫學中心的研究，但 所收集的病人有地域性，因此此研究結果或許不適合外推到其他族群的病人身 上．
參考文獻
中文文獻
1. 呂博弘、陳春萬、張振平 (2006)．陽台通風影響瓦斯熱水器一氧化碳累積 之研究．勞工安全衛生研究季刊，14(4)，299-307.
2. 邱彥文、王建楠、吳政龍、蘇世斌(2005)．淺談一氧化碳中毒．基層醫學，
2 0 ( 11 )，302-307.
3. 林佳谷、陳叡瑜 (2007)．一氧化碳性格．工業安全衛生月刊，215(1)，28-34.
4. 林貴滿(2003)．一氧化碳中毒．實用急症護理學．台北：華杏.
5. 陳育聲(2005)．一氧化碳中毒與神經精神狀態變化及治療．台灣醫界， 4 8 ( 3 ) ， 1 4 -16 .
6. 陳瓊芳、宋文舉(2002)．一氧化碳中毒．中華民國兒童胸腔醫學會刊， 3(1)，
1-10.
7. 陳興漢、呂鴻基(2003)，以高壓氧治療氣體中毒，中華職業醫學雜誌，
10(2):55-62.
8. 陳耀仁、蔡素如、蔡岳霖(2008)，遲發性缺氧性腦病變後之復健:病例報告，
台灣復健醫誌 2008; 36(2): 111-117.
9. 唐月學、曾志、向大 (2008)．高壓氧及綜合治療急性一氧化碳中毒所致皮 質盲 10 例分析．中國誤診學雜誌，8(6)，1483-1484.
10. 劉伯瑜、洪東榮、歐長憲(2005)，一氧化碳中毒之神經精神併發症，臨床醫 學，56(6)，391-395.
英文文獻
1. Buckley, N.A., Isbister, G.K., Stokes, B., et al. Hyperbaric oxygen for carbon monoxide poisoning: a systematic review and critical analysis of the evidence.
Toxicol Rev. 2005;24:75-92.
2. Bohan, J.S., Benefit of hyperbaric oxygen therapy for acute carbon monoxide poisoning. J Watch Emerg Med. 2002;6:81.
3. Choi, I.S., Delayed neurologic sequelae in carbon monoxideintoxication. Arch Neurol 1983;40:433-5.
4. Choi, I.S., Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol. 1983;40:433-435.
5. Chang, S.S., Gunnell, D., Wheeler, B.W., Yip, P., Sterne, J.A., The evolution of the epidemic of charcoal-burning suicide in Taiwan: a spatial and temporal analysis. PLoS Med. 2010;7:e1000212.
6. Deschamps, D., Geraud, C., Julien, H., et al. Memory one month after acute carbon monoxide intoxication: a prospective study. Occup Environ Med.
2003;60:212-216.
7. Ernst, A., Zibrak, J.D., Carbon monoxidepoisoning. NEJM 1998; 339: 1603-8.
8. Ernst, A, Zibrak, J.D., Carbon monoxide poisoning. N Engl J Med. 1998;
339:1603–1608.
9. Forbes, W.H.,Sargent, F., Roughton, F.J.W., Rate of carbon monoxide uptake by normal men, Am J Physiol 1945;143:594-608.
10. Garrabou, G., Inoriza, J. M., Moren, C., Oliu, G., Miro, O., Marti, M. J., et al.
(2011). Hyperbaric oxygen therapy for carbonmonoxide poisoning. Intensive Care Medicine, 37(10), 1711-1712.
11. Gorman, D., Drewry, A, Huang,Y.L., Sames,C., The clinical toxicology of carbon monoxide. Toxicology 2003; 187:25–38.
12. Hu, H., Pan, X., Wan, Y., Zhang, Q., Liang, W., Factors affecting the prognosis of patients with delayed encephalopathy after acute carbon monoxide poisoning.
Am J Emerg Med. 2011;29:261-264.
13. Hampson, N.B., Dunford, R.G., Kramer, C.C., Norkool, D.M., Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning. J Emerg Med. 1995; 13:227–231.
14. Hampson, N.B., Mathieu, D., Piantadosi, C.A., Thom, S.R., Weaver, L.K. ,Carbon monoxide poisoning: interpretation of randomized clinical trials and unresolved treatment issues. Undersea Hyperb Med. 2001; 28:157–164.
15. Hardy, K.R., Thom, S.R., Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol 1994; 32:613.
16. Hampson, N.B., Hauff, N.M., Risk factors for short-term mortality from carbon
monoxide poisoning treated with hyperbaric oxygen. Crit Care Med 2008;
36:2523.
17. Huang, C.C., Chung, M.H., Weng,S.F. et al., Long-term prognosis of patients with carbon monoxide poisoning: a nationwide cohort study. PLoS One.
2014;9:e105503.
18. Helms, A.K., Whelan, H.T., Torbey, M.T., Hyperbaric oxygen therapy of cerebral ischemia. Cerebrovasc Dis. 2005;20:417-426.
19. Hampson, N.B., Mathieu, D., Piantadosi, C.A., et al. Carbon monoxide poisoning: interpretation of randomized clinical trials and unresolved treatment issues. Undersea Hyperb Med. 2001;28: 157-164.
20. Hampson, N.B., Weaver, L.K., Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med. 2007;34:163-168.
21. Hampson, N.B., Piantadosi, C.A., Thom, S.R., Weaver, L.K., Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186:1095-1101.
22. Juurlink, D.N., Buckley, N.A., Stanbrook, M.B., et al. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database of Systematic Reviews; 2005;
issue 1
23. Ku, H. L., Yang, K. C., Lee, Y. C., Lee, M.B., & Chou, Y. H. (2010). Predictors of carbonmonoxide poisoning delayedneuropsychological sequelae. General
Hospital Psychiatry, 32(3), 310-314.
24. Ku, C.H., Hung, H.M., Leong, W.C., et al. Outcome of patients with carbon monoxide poisoning at a Far-East poison center. PLoS One. 2015;10
25. Latham, E., Hare, M.A., Neumeister, M., et al. Hyperbaric oxygen therapy.
Accessed from
http://emedicine.medscape.com/article/1464149-overview#aw2aab6b6 on April 11, 2015.
26. Liu, K.Y., Beautrais, A., Caine, E., et al. Charcoal burning suicides in Hong Kong and urban Taiwan: an illustration of the impact of a novel suicide method on overall regional rates. J Epidemiol Community Health. 2007;61:248-253.
27. Mathieu, D., Wattel, F., Mathieu-Nolf, M., et al. Randomized prospective study comparing the effect of HBO2 versus 12 hours of NBO in non comatose CO poisoned patients: results of the interim analysis [abstract]. Undersea Hyperb Med. 1996;23:7-8.
28. O’Donnel, P., Buxton, P.J., Pitkin, A., Jarvis, L.J., The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning. Clin Radiol 2000; 55:273–280.
29. Omaye, S.T., Metabolic modulation of carbon monoxide toxicity. Toxicology 2002; 180:139–150.
30. Parkinson, R.B., Hopkins, R.O., Cleavinger, H.B., et al. White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology. 2002;58:1525-1532.
31. Prockop, L.D., Carbon monoxide brain toxicity: clinical, magnetic resonance imaging, magnetic resonance spectroscopy, and neuropsychological effects in 9 people. J Neuroimaging 2005; 15:144–149.
32. Peterson, J.E., Stewart, R.D., Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health. 1970;21: 165-171.
33. Pace, N., Strajman, E., Walker, E.L., Acceleration of carbon monoxide elimination in man by high pressure oxygen. Science. 1950;111: 652-654.
34. Phin, N., Carbon monoxide poisoning (acute). Clin Evid. 2005;13:1732-1743.
35. Pan, Y.J., Liao, S.C., Lee, M.B., Suicide by charcoal burning in Taiwan, 1995-2006. J Affect Disord. 2010;120:254-257.
36. Raphael, J.C., Elkharrat, D., Jars-Guincestre, M.C., et al. Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet.
1989;2:414-419.
37. Sosiak, T., Evans, W., Hyperbaric medicine in Ontario: clinical overview, resource challenges. Ontario Med Rev. 2005;May:51-54.
38. Samoli, E., Aga, E., Touloumi, G., Nisiotis, K., Forsberg, B., Lefranc, A., et al.
2006. Short-term effects of nitrogen dioxide onmortality: an analysis within the
APHEA project. Eur RespirJ 27(6):1129–1138.
39. Schwartz, J., 1997. Air pollution and hospital admissions for cardiovascular disease in Tuscon. Epidemiology 8:371–377.
40. Samoli, E., Touloumi, G., Schwartz, J., Anderson, H.R., Schindler, C., Forsberg, B., Vigotti, M.A., Vonk, J., Kosnik, M., Skorkovsky, J., Katsouyanni, K., Short-term effects of carbon monoxide on mortality: an analysis within the APHEA project. Environ Health Perspect. 2007 Nov;115(11):1578-83.
41. Smith, G., The treatment of carbon monoxidepoisoningwith oxygen at rwo atmospheresabsolute, Ann Occup Hyp1962; 5: 259-263.
42. Seger, D., Welch, L., Carbon monoxidecontroversies: neuropsychologic testing,mechanism of toxicity, and hyperbaricoxygen, Ann Emerg Med 1994; 24:
242-248.
43. Smith, G., Sharp, G.R., Treatment of carbon-monoxide poisoning with oxygen under pressure. Lancet. 1960;October:905-906.
44. Scheinkestel, C.D., Bailey, M., Myles, P.S., et al. Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomized controlled clinical trial. Med J Aust. 1999;170:203-210.
45. Thom, S.R., Hyperbaric-oxygen therapy for acute carbon monoxide poisoning. N Engl J Med. 2002;347:1105-1106.
46. Thom, S.R., Taber, R.L., Mendiguren, I.I., Clark, J.M., Hardy, K.R., Fisher, A.B., Delayed neuropsychologic sequelae after carbon monoxide poisoning:
prevention by treatment with hyperbaric oxygen. Ann Emerg Med.
1995;25:474-480.
47. Touloumi, G., Samoli, E., Katsouyanni, K., 1996. Daily mortality and“winter type” air pollution in Athens, Greece-a time series analysis within the APHEA project. Am J Epidemiol Community Health 50(suppl 1):S47–S51.
48. Tibbles, P.M., Perrotta, P.L., Treatment of carbon monoxide poisoning: a critical review of human outcome studies comparingnormobaric oxygen with hyperbaricoxygen, Ann Emerg Med 1994; 24:269-276.
49. Tibbles, P.M., Perrotta, P.L., Treatment of carbon monoxide poisoning: a critical review of human outcome studies comparing normobaric oxygen with hyperbaric oxygen. Ann Emerg Med 1994; 24:269.
50. Thom, S.R., Bhopale, V.M., Fisher, D., Zhang, J., Gimotty, P., Delayed neuropathology after carbon monoxide poisoning is immune-mediated. Proc Natl Acad Sci U S A. 2004;101:13660-5.
51. Thom, S.R., Bhopale, V.M., Fisher,D., Hyperbaric oxygen reduces delayed immune-mediated neuropathology in experimental carbon monoxide toxicity.
Toxicol Appl Pharmacol 2006; 213:152–159.
52. Weaver, L.K., Clinical practice. Carbon monoxide poisoning. N Engl J Med.
2009;360:1217-1225.
53. Weaver,L.K., Hopkins,R.O., Chan,K.J., et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002;347:1057-1067.
54. Weaver, L.K., Valentine, K.J., Hopkins, R.O., Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. Am J Respir Crit Care Med. 2007;176:491-497.
55. Wolf, S.J., Lavonas, E.J., Sloan, E.P., Jagoda, A.S., American College of Emergency Physicians. Clinical policy: Critical issues in the management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann Emerg Med. 2008;51:138-152.
56. Weaver, L.K., Howe, S., Hopkins, R., et al. Carboxyhemoglobin half-life in carbon monoxide-poisoned patients treated with 100% oxygen at atmospheric pressure. Chest. 2000;117:801-808.
57. Zou,J.F., Guo, Q., Shao, H, et al. Lack of pupil reflex and loss of consciousness predict 30-day neurological sequelae in patients with carbon monoxide poisoning.
PLoS One. 2015;10:e0119126.
58. Zhang, J., Piantadosi, C.A., Mitochondrialoxidative stress after carbon monoxidehypoxia in the rat brain, J Clin Invest 1992; 90:1193-1199.
59. Zou,J.F., Guo, Q., Shao, H., Li, B., Du, Y, Liu, M., Liu, F., Dai, L, Chung, M.H., Lin, H.J., Guo, H.R., Yang, T.M., Huang, C.C., Hsu, C.C., A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon
monoxide poisoning. Biomed Res Int. 2014;2014:814736.
網站文獻
1. 台灣內政部消防署災防週報。摘自
http://www.cdprc.ey.gov.tw/Upload/RelFile/3007/706261/65985ff5-8a 6c-472f-b234-fa181b1d507.pdf on July 11, 2015.
2. 奇美醫院網頁。摘自
http://www.chimei.org.tw/97_newindex/layers2/cmh_yongkang.html on July 22, 2015。
3. 台灣自殺防治學會．防治策略．摘自
http://tspc.tw/tspc/portal/theme/index.jsp?sno=77 on August 2, 2015 4. 內政部消防署全球資訊網．摘自
http://www.nfa.gov.tw/main/Unit.aspx?ID=&MenuID=500&ListID=315 on August 2, 2015.
5. 維基百科網頁。摘自
https://zh.wikipedia.org/zh-tw/SPSS#.E5.8F.83.E8.80.83.E6.96.87.E 7.8D.BB on November 04,2015.
圖一．收案內容
圖二．美國國家消防協會 NFPA（National Fire Protection Association）編 著之防火手冊，提出一氧化碳含量對於人體吸入時間及中毒症狀如下：