目的 探讨一氧化碳中毒后迟发性脑病的临床表现.方法 选取2011-01—2016-01收治的一氧化碳中毒患者81例为研究对象,将其中21例一氧化碳中毒后迟发性脑病患者及60例一氧化碳中毒非迟发性脑病患者进行分析.结果 一氧化碳中毒后迟发性脑病患者临床表现多以痴呆为主,并伴震颤麻痹及其他精神病症,较少出现局灶损害和舞蹈症.脑电图主要是广泛的慢波改变,在头部影像上常见其双侧脑白质出现异常化改变.在中毒治愈后,经30 d观察可知中毒病人较少出现迟发性脑病.就危险性而言,昏迷时间与高压氧疗属于一氧化碳中毒迟发性脑病的独立因素,当患者昏迷>10 h时,发生迟发性脑病的几率有明显提高.结论 一氧化碳中毒昏迷>10 h时,则应警惕其迟发性脑病的发生率,使用高压氧疗以降低发病率.%Objective To investigate the clinical manifestations of delayed encephalopathy caused by carbon monoxide poi-soning .Methods The 81 patients with toxic encephalopathy who were admitted from January 2011 to January 2016 were selected as the study subjects .Among them ,21 patients with delayed encephalopathy caused by carbon monoxide poisoning and 60 patients with delayed encephalopathy without carbon monoxide poisoning were compared and analyzed .Results Delayed encephalopathy of carbon monoxide poisoning was mostly dementia accompanied by paralysis and other mental disorders ,with less focal lesion and chorea .EEG test showed mainly a wide range of slow wave changes and abnormal images in bilateral abnormalities of white mat-ter .After the poisoning was cured ,patients had less delayed encephalopathy 30 days after treatment .In terms of risk ,coma time and hyperbaric oxygen therapy were independent factors of delayed carbon monoxide poisoning encephalopathy ,when the patient coma time exceeds 10 h ,the probability of delayed encephalopathy was significantly increased .Conclusion The risk of carbon monoxide poisoning delayed encephalopathy is higher when the duration of coma is over 10 h .The hyperbaric oxygen therapy should be applied to reduce the incidence of delayed encephalopathy .
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