急性一氧化碳中毒后迟发性脑病46例临床分析

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。方法对本院2003年1月—2006年1月收治的46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46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;36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%(20/46),脑电图异常率为100%(32/32),CT异常率为69.6%(32/46),MR I 92%(23/25)。全组痊愈32例,好转13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。

Clinical Analysis on 46 Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning

Objective To sum up the clinical characteristics of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)Methods Data,such as manifestation,imaging,electroencephalogram(EEG),electrocardiogram(ECG),therapy and prognosis,were retrospectively analyzed on the 46 patients with DEACMP admitted to the hospital from Jan.2003 to Jan.2006Results All the patients suffered 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,36 suffered from the disorder of extrapyramidal system and some suffered from that of pyramidal system.The abnormal rates of ECG,EEG,computerized tomography(CT) and magnetic resonance imaging(MRI) were 43.5%(20/46),100.0%(32/32),69.6%(32/46) and 92.0%(23/25),respectively.At last,there were 32 patients who healed up,13 who improved,and one who died.Conclusion The main manifestation of DEACMP consists of consciousness disorders and functional disorders of extrapyramidal and pyramidal system.The patients' disability rate will be high as soon as they occur.