急性CO中毒迟发脑病的影响因素及MRI特点分析

目的探讨急性CO中毒迟发脑病的影响因素及MRI特点。方法回顾性分析45例急性CO中毒后昏迷病人的病例资料,按是否发生迟发脑病分为迟发脑病组(22例)和对照组(23例),比较2组临床相关资料的差异。结果迟发脑病组在年龄、昏迷时间、中毒程度、并发症、高压氧治疗时间与对照组相比差异有统计学意义(P<0.05),迟发脑病组MRI改变分为弥漫性白质病变、皮质改变及基底节神经核团改变三种,多合并存在。结论年龄、昏迷时间、中毒程度、并发症是急性CO中毒后发生DEACMP的重要影响因素,高压氧治疗对DEACMP的预防及改善预后均有一定帮助。对急性CO中毒患者,应根据每个人病情特点,结合头颅MR检查结果进行个体化评估,对一些有潜在DEACMP发病可能的病例,应积极进行规律长疗程的高压氧治疗以尽可能改善预后。

Analysis of influence factors and MRI features in the patients with delayed encephalopathy after acute carbon monoxide poisoning

Objective To explore the influence factors and MRI features of delayed encephalopathy(DEACMP)after acute carbon monoxide(CO) poisoning.Methods Forty-five patients which were unconscious after acute CO poisoning were collected and were divided into delayed encephalopathy group(22 cases)and control group(23 cases) according to the occurrence of DEACMP.Clinical informations were compared between the two groups.Results There were significant differences between the two groups in age,duration of unconscious,degrees of poisoning,complications,time of hyperbaric oxygen therapy(P<0.05).The changes of MRI on DEACMP included diffuse white matter lesions,cortical changes and basal ganglia nucleus change,many in combination.Conclusion Age,duration of unconscious,degrees of poisoning,complications are important factors which influence the occurrence of DEACMP after acute CO poisoning,hyperbaric oxygen therapy is important in DEACMP prevention.Patients with acute CO poisoning should be individualized assessment according to disease characteristics and MRI imaging results,long course of hyperbaric oxygen therapy is useful for the improvement of prognosis.