老年人急性一氧化碳中毒迟发脑病30例临床分析

Clinical analysis on 30 cases of old men with acute carkon monxide intoxication delayed encephalopathy

目的:研究老年人急性一氧化碳中毒迟发性脑病的临床表现、影像学特征及其早期治疗和预后,加深对这种疾病的认识。方法:回顾性分析从1995年至2005年我院收治的60岁以上的30例患者的临床资料。结果:老年人急性一氧化碳中毒迟发性脑病的临床表现是复杂多样的,以痴呆、二便失禁、智能障碍为主。CT和MRI提示:脑内白质的对称性类圆形低密度影。治疗强调早期激素治疗,高压氧治疗和改善局部脑血液循环,减轻血管内皮损伤的治疗,预后良好。结论:老年人急性一氧化碳中毒迟发性脑病的程度与年龄、昏迷时间、一氧化碳浓度、既往病史等因素相关,而且与在治疗上早期应用激素和其他治疗时间不少于一个月相关。

Objective To study the clinical manifestation, imaging characteristics, early treatment and prognosis of delayed encephalopathy after carbon monoxide poisoning （DEACMP） and deepen the cognition of the disease. Method We collected and analyzed the clinical data of 30 patients with DEACMP who were more than 60 years retrospectively and they all in-hospitaled from 1995 to 2005. Results The clinical manifestation of DEACMP is complicated and dementia, urinary and fecal incontinence, intellectual defect are the main ones. CT and MRI show symmetric density reduction images similar to round in the white matter. The key to the treatment are hormone therapy, hyperbaric oxygen supply, improving local cerebral blood circulation and decreasing injury of blood vessel endothelium. The prognosis of DEACMP is good. Conclusion The degree of DEACMP is closely related to the age, persistence time of coma, concentration of CO aspirated, et al, also related to hormone treatment early and other treatments more than one month.