急性一氧化碳中毒迟发性脑病48例临床分析

摘要

目的：研究急性一氧化碳中毒迟发性脑病（DEACMP）患者的临床表现、脑电图、心电图、影像学特征及其早期治疗和预后。方法对2005～2013年本院收治的48例DEACMP患者的临床资料进行回顾性分析。结果急性一氧化碳中毒迟发性脑病的临床表现复杂多样，以痴呆、二便失禁或储留、智能障碍、平衡障碍、四肢肌张力增高为主。CT和MRI提示广泛性脑白质损害。治疗强调早期高压氧治疗、防治脑水肿、激素、营养神经、和改善局部脑血液循环，促进细胞代谢、以及康复综合治疗，多数预后良好。结论急性一氧化碳中毒迟发性脑病的程度与一氧化碳吸入时间、高压氧的介入时间、发病年龄、昏迷时间、一氧化碳浓度、并发症等因素相关，且与综合治疗的疗程相关。%Objective To analyze the clinical features,early treatment and prognosis of patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP). Methods The clinical data of 48 cases of DEACMP patients in the 2005~2013 years in this hospital were retrospectively analyzed. Results The clinical manifestations of delayed encephalopathy after acute carbon monoxide poisoning complicated with dementia, incontinence or retention,disturbance of intel igence,balance impairment,limb muscle tension increase. CT and MRI suggest widespread cerebral white matter damage. Treatment focuses on early hyperbaric oxygen treatment and prevention of brain edema,hormone,nutrition nerve,and improve local cerebral blood circulation,promote cel metabolism,and the comprehensive rehabilitation treatment,most of the good prognosis. Conclusion Delayed encephalopathy after acute carbon monoxide poisoning of carbon monoxide inhalation,degree and time of hyperbaric oxygen in the intervening time,age of onset,duration of coma,the concentration of carbon monoxide,complications and other relevant factors,treatment and comprehensive treatment of the relevant.