60例一氧化碳中毒患者脑电图分析及对迟发性脑病的预测价值∗

摘要

Objective To observe the changes of electroencephalography (EEG)of patients with carbon oxide (CO)poisoning so as to explore the predictive value of EEG on patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP ).Methods A total of 60 patients with CO poisoning who received emergency treatment were given EEG examination within 24 h after hospitalization,and were examined every 7-10 d until discharge.EEG examination was given to DEACMP within 24 h,7 d and 14 d after onset.Results After treatment,24 patients had DEACMP and were set as DEACMP group,and 36 patients without psychological symptoms served as non-DEACMP group.DEACMP patients were clinically marked by mental and intellectual disability and extrapyramidal system symptoms.The initial EEG abnormality rates were 91.66% (22/24 )and 66.67% (24/36 )in DEACMP group and non-DEACMP group respectively,and were 70.83% (1 7/24 ) and 36.1 1% (13/36)in moderate and severe EEG abnormality groups respectively,and all differences were statistically significant (P < 0.05 ).Compared with acute CO poisoning period,the EEG abnormality rate was increased to 95.83% (23/24)in DEACMP group in disease attack period,but there was no statistically significant difference (P >0.05).Conclusion Acute CO poisoning patients with moderate and severe EEG abnormality are more likely to have DEACMP,and the EEG symptoms are parallel to clinical course development.Therefore,early surveillance on EEG is of great significance in predicting DEACMP.%目的：探讨脑电图(EEG)监测对急性一氧化碳(CO)中毒后迟发性脑病(DEACMP)的预测价值。方法60例 CO 中毒患者接受急救治疗,于入院24 h 内首次检查 EEG 及头颅 CT,随后每隔7~14 d 复查直至出院。结果治疗后24例发生 DEACMP,设为 DEACMP 组,36例未出现精神症状,设为对照组。DEACMP 患者临床表现以精神和智能障碍、锥体外系表现为主。DEACMP 组和对照组首次 EEG 异常率分别为91.67%(22/24)和66.67%(24/36),中、重度 EEG 异常分别为70.83%(17/24)和36.11%(13/36),差异有统计学意义(P <0.05)。与急性 CO 中毒期比较,DEACMP 组发病期 EEG 异常率增高至95.83%(23/24),但差异无统计学意义(P >0.05)。结论中、重度 EEG 异常的急性 CO 中毒患者更易发生 DEACMP,其 EEG 表现与临床病程发展平行,早期监测 EEG 对预测 DEACMP 具有积极意义。