慢性阻塞性肺疾病急性加重期意识障碍的原因分析

目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)意识障碍的原因.方法 对2004年1月至2008年6月AECOPD患者的临床资料进行回顾性分析.结果 5年来收治AECOPD患者310例,发生意识障碍16.8%(52/310):肺性脑病29例、低渗性脑病12例、脑梗死7例、药物引起4例;临床上症状常表现多样化,可无特征性,但是由其引起死亡达死亡总数的55.6%(10/18).结论 AECOPD意识障碍发生率较高,且很难完全避免;应注意鉴别,可先要行头颅CT或MRI检查以排除颅内器质性病变,再根据动脉血气分析、血电解质等检查进一步明确病因.

Analysis of the reasons caused disturbance of consciousness in chronic obstructive pulmonary disease with a-cute exacerbation

Objective To investigate the chronic obstructive pulmonary disease with acute exacerbation(AE-COPD) of eonseiousneas. Methods For January 2004 to June 2008, AECOPD clinical data were reviewed retroepec-tively. Results 5 yeats treated 310 eases with AECOPD,impaired consciousness occurred in 16. 8% (52/310) : 29cases of pulmonary encephalopathy, hypotonic encephalopathy 12 cases ,5 cases of cerebral infarctinn,4 cases of drug-induced;clinical symptoms often show a variety,may be characteristic,but the cause of death by up to 55.6% of the total number of deaths(10/18). Conclusion AECOPD had high incidence of disturbance of eonseiousneas,and it isdiflleult to avoid completely;should pay attention to identify,first perform head CT or MR/examination to exclude or-ganic brain disease,according to arterial blood gas analysis,bloed electrolyte,to further determine the cause.