急性一氧化碳中毒后的迟发性脑病

目的:分析急性一氧化碳中毒导致迟发性脑病的发生机制和临床表现,探讨其综合治疗的方法和预后的影响因素。资料来源:应用计算机检索中国期刊全文数据库1983-01/2000-10和CBMdise相关文章。检索词“急性、一氧化碳中毒、迟发性、脑病”,限定文章语言种类为中文。资料选择:对资料进行初审,选取有关急性一氧化碳的发病机制、临床表现、治疗和预后的相关文章。纳入标准:①随机对照临床研究。②不限定盲法。排除标准:重复的同一研究。资料提炼:共收集到240篇关于急性一氧化碳中毒导致脑病的相关文献,24篇符合纳入标准。资料综合:急性一氧化碳中毒导致脑病的发病机制较为复杂,临床表现从症状、体征、脑电图、脑CT、磁共振方面来加深对该病的认识。治疗方法常采用:①神经细胞活化剂、血管扩张剂、抗凝剂及维生素。②高压氧。③紫外线照射充氧自血回输疗法。④针刺疗法。影响急性一氧化碳中毒后迟发性脑病预后的因素常与年龄、中毒程度、并发症及其救治的时间有关。结论:急性一氧化碳中毒可以导致脑病的发生,是多种机制共同作用的结果。目前尚无特异性的治疗方法,应采取综合治疗,但治疗效果不理想,可遗留不同程度的智力及肢体功能障碍,长期存在睁眼昏迷。

Delayed encephalopathy after acute carbon monoxide poisoning

OBJECTIVE: To analyze the pathogenesis and clinical manifestations of delayed encephalopathy after acute carbon monoxide poisoning, and to investigate the method of complex treatment and the factors influencing prognosis.DATA SOURCE: Related papers were searched by computer in Chinese Journal Full-text Database (CJFD) from January 1983 to October 2000 and CBMdise with the terms of "acute, carbon monoxide poisoning, delayed,encephalopathy", and the language of paper was limited to Chinese.STUDY SELECTION: The papers relevant to the pathogenesis, clinical manifestation, treatment and prognosis of acute carbon monoxide poisoning were collected preliming screening. Inclusion criteria: ① Randomized controlled trial. ② Blind method was not restricted. Exclusion criteria: The same researches repeated.DATA EXTRACTION: A total of 240 pieces of paper related to acute carbon monoxide poisoning induced eneephalopathy were collected, among which, 24 pieces accorded with inclusion criteria.DATA SYNTHESIS: The pathogenesis of acute carbon monoxide poisoning induced encephalopathy was relatively complex, which should be deeply recognized from the clinical manifestations such as symptom, sign,electroencephalogram, cerebral CT and MRL The therapeutic methods included ①Neural cell agonist, vasodilator, anticoagulant and vitamin ②High pressure oxygen ③ Ultraviolet blood irradation and oxygenation, UBIO. ④ Acupuncture therapy. The factors influencing prognosis of delayed encephalopathy after acute carbon monoxide poisoning were usually related to age, degree of poisoning, complications and cure time.CONCLUSION: Acute carbon monoxide poisoning can cause encephalopathy, which is the result of multiple pathogenesis. There is no special treatment for it until now, and complex treatment should be used, but the curative effect is not ideal, and intellectual disturbance and extremity function disorder of different degree might be left after treatment, and agrypnocoma would exist for a long time.