急性一氧化碳中毒后迟发性脑病24例临床特征分析

Clinical analysis on 24 patients with delayed encephalopathy after acute carbon monoxide poisoning

关键词:  一氧化碳  中毒  迟发性脑病

Key words:  carbon monoxide  poisoning  delayed encephalopathy

摘要:

［目的］总结急性一氧化碳中毒后迟发性脑病(DEACMP)的有关临床特征。［方法］对2000年6月~2006年6月收治的24例DEACMP患者临床表现、影像学、脑电图、心电图、治疗及预后等进行回顾分析。［结果］24例均有意识障碍。主要表现为意识内容改变，少数表现为意识水平受损，持续时间(12.5±5.8) h，假愈期(10.5±6.2) d；14例有锥体外系功能障碍。部分病例有锥体系功能障碍。心电图检查异常率为43.5%(10／24)，脑电图异常率为100%(24／24)，CT异常率为66.6%(16／24)，MRI 异常率为83.3%(10／12)。全组痊愈及显效16例，好转7例，死亡1例。［结论］DEACMP主要表现为意识障碍、锥体外系和锥体系功能障碍，一经发生治疗较困难，致残率高。

Abstract:

［Objective］To sum up the clinical characteristics of delayed encephalopathy after acute carbon monoxide peisoning(DEACMP).［Methods］Data such as manifestation,imaging, electroencephalogram(EEG), electrocardiogram (ECG), thempy and prognosis, were retrospectively analyzed on the 24 patients with DEACMP admitted to the hospital from Jan.2000 to Jan .2006 Results All the patients sufered from consciousness disorders whose main manifestation was of the change in consciousness The disorders sustained for (12.5±5.8) hours and their pseudo healing duration was (10.5±6.2) days.of the patients, 14 sufered from the disorder of extrapyramidal system and some sufered from that of pyramidal system.The abnormal rates of ECG EEG,computerized tomography(CT)and magnetic resonance imaging(MRI)were 43.5% (10／24), 100.0% (24／24), 66.6%(16／24)and 83.6% (10／12), respectively.At last, there were 16 patients who healed up and appareng rate,7 who improved, and one who died.［Conclusions］The main manifestation of DEACMP consists of consciousness disorders and functional disorders of extrapyramidal an d pyramidal system.The patients disability rate will be high as soon as they occur.