COPD患者意识障碍原因分析

目的分析COPD患者精神和意识障碍的原因.方法回顾性分析了医院呼吸内科近3年收治的425例诊断为COPD的患者.结果其中出现神经精神症状和意识障碍的118例,占住院COPD患者的28%;由肺性脑病引起者40例,占有意识障碍人数的34%;肺心病的并发症53例,占45%:其中电解质和酸碱代谢紊乱29例;消化道出血和DIC 13例,感染中毒性脑病和感染中毒性休克8例,肝肾功能衰竭3例;药物引起者共18例,占15%;其它伴发病引起者7例,占6%:其中心脑血管病4例,糖尿病低血糖昏迷1例,癫痫2例.结论 COPD患者一旦出现意识障碍,并非都是肺性脑病所致,需要仔细分析和鉴别,不同的原因需要不同的处理方法.

Clinical analysis of conscious disorder in patients with COPD

To investigate the causes of conscious disorder (coma mental confusion and excitement et al) in patients with COPD (chronic obstructive pulmonary diseases, COPD). 425 patients diagnosed COPD referred to Wuhan General Hospital in recently three years were investigated. 118 cases of all the patients suffered conscious and psychical disorder. The conscious disorder caused by pulmonary encephalopathy were 40 cases, thirth-fourth percent in this group patients. 53 cases of the patients, forth-fifth percent the causes of conscious disorder were considered as the complications of COPD, included of acid-basic metabolic and electrolytic disturbance (29 cases), hemorrhage of digestive tract and DIC (13 cases), infective shock (8 cases), liver and renal function failure (3 cases). Drug resulted in mental confusion and dependence in 18 cases , fifteen percent of the all . The symptoms aroused by others diseases gave six percent (7 cases). [Conclusions] There are different causes , and must be the different treatments to conscious disorder in patients with COPD.