引用本文:覃慧悦,盘晓荣,梁瑞芬.广西急性一氧化碳中毒后迟发性脑病的预后因素分析[J].中国临床新医学,2015,8(6):544-547.
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广西急性一氧化碳中毒后迟发性脑病的预后因素分析
覃慧悦,盘晓荣,梁瑞芬
530100 广西,武鸣县人民医院高压氧科(覃慧悦);530021 南宁,广西壮族自治区人民医院高压氧科(盘晓荣);530012 南宁,广西壮族自治区江滨医院高压氧科(梁瑞芬)
摘要:
[摘要] 目的 收集广西部分医院急性一氧化碳中毒后迟发性脑病(DEACMP)患者的临床资料,分析影响DEACMP预后的因素。方法 回顾分析2008~2014年广西武鸣县人民医院、广西区人民医院、广西区江滨医院住院的52例DEACMP患者的临床资料,病后3个月根据患者日常生活能力量表(ADL)的评分结果分为无效组25例和好转组27例,分别比较两组患者性别、年龄、基础疾病、暴露在CO中的时间、昏迷时间、假愈期、急性期是否高压氧(HBO)治疗、并发症、早期头颅CT、MRI是否异常、入院时心肌酶谱、心电图、血白细胞总数是否异常、入院时ADL评分以及是否使用依达拉奉15项可能影响DEACMP预后的因素。结果 年龄、暴露在CO中的时间、假愈期、急性期是否行HBO治疗、并发症、早期头颅MRI是否异常、入院时ADL评分与DEACMP患者预后相关(P<0.05),其中年龄、暴露在CO中的时间、入院时ADL评分意义更大(P<0.01),而其余因素对DEACMP患者预后无明显影响(P>0.05)。结论 年龄较大、暴露在CO中的时间长、假愈期较短、急性期未行HBO治疗、早期头颅MRI异常、并发症以及入院时ADL评分较低均提示DEACMP患者预后差,应高度警惕。
关键词:  广西  急性一氧化碳中毒  迟发性脑病  预后
DOI:10.3969/j.issn.1674-3806.2015.06.16
分类号:R 742
基金项目:
Analysis of prognosis factors of patients with delayed encephalopathy after acute carbon monoxide poisoning in Guangxi
QIN Hui-yue, PAN Xiao-rong, LIANG Rui-feng
Department of Hyperbaric Oxygen, the People′s Hospital of Wuming County, Guangxi 530100, China
Abstract:
[Abstract] Objective To analyze the factors affecting the prognosis in patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods Fifty-two DEACMP cases were collected from the people′s hospital of Wuming county, the people′s hospital of Guangxi Zhuang Autonomous region and the Jiangbin hospital of Guangxi Zhuang Autonomous region from 2008 to 2014 and were retrospectively studied. According to the results of patients′ daily life ability scale(ADL) scores 3 months after the illness, the patients were divided into non-improvement group(n=25) and improvement group(n=27) on the basis of their recovery progress. The factors affecting the prognosis of DEACMP patients including gender, age, primary diseases, exposure time within the CO, unconsciousness duration, pseudo-recovery period Hyperbaric oxygen(HBO) treatment in acute phase, brain magnatic resonance imaging(MRI) scan, daily life ability scale(ADL) score on admission, and use of Edaravone were compared between the two groups.Results Age, exposure time within the CO, pseudo-recovery period, HBO treatment in acute stag, complications, abnormal in early brain MRI scan and the higest ADL scores were related to the prognosis of DEACMP patients(P<0.05). Other factors such as gender, primary diseases, unconsciousness duration, brain CT scan, edaravone had no significantly differences(P>0.05).Conclusion Aging, complications, long time exposure to CO, shorter pseudo-recovery period, HBO treatment in acute stag, abnormal in early brain MRI scan and lower ADL scores indicate poor prognosis in DEACMP patients. More attentions should be paid to the treatment of patients who have these disorders.
Key words:  Guangxi  Carbon monoxide poisoning  Delayed encephalopathy  Prognosis