COPD患者合并意识障碍的原因分析附50例报告

The analysis about causes of COPD patients with disturbance-report of 50 cases

目的探讨引起慢性阻塞性肺疾病(C0PD)合并意识障碍的病因构成及防治。方法回顾性分析260例COPD患者的临床资料,通过体格检查、血气分析、电解质、头颅CT、MRI等检查综合判断意识障碍病因构成,分析其特征。结果 260例COPD患者出现不同程度的意识障碍50例,临床表现为失眠、烦躁、淡漠、兴奋,躁动不安、神志模糊,嗜睡、昏睡及昏迷等,其病因构成肺性脑病50.00%、低渗性脑病26.00%、脑血栓14.00%、药物不良反应10.00%。治疗意识障碍纠正46例,死亡4例:肺性脑病2例、低渗性脑病1例、脑梗死1例。结论 COPD合并意识障碍病因复杂,症状多样化,特异性不强,应实施针对性血气分析、血电解质、头颅CT等检查,提高诊断水平,及时采取相应的措施。

Objective Cause of 226001 chronic obstructive pulmonary disease （COPD） combined constitute the cause of disturbance of consciousness and control.Methods Retrospective analysis of 260 cases of clinical data of COPD patients,by physical examination,blood gas analysis,electrolytes,head CT,MRI and other tests,constitute a comprehensive determine the cause of consciousness,are analyzed.Results 260 cases of COPD patients with different degrees of consciousness,50 cases of clinical manifestations of insomnia,irritability,indifference,excitement,irritability,fuzzy mind,lethargy,drowsiness and coma,which causes constitute 50.00% of pulmonary encephalopathy,hypotonic 26.00% encephalopathy,cerebral thrombosis 14.00%,10.00% of adverse drug reactions.Correct treatment of 46 cases of disturbance of consciousness and death in 4 cases： 2 cases of pulmonary encephalopathy,hypotonic encephalopathy in 1 case,1 case of cerebral infarction. Conclusion COPD causes of complex merger of consciousness,symptoms of diverse specificity is not strong,should implement targeted blood gas analysis,blood electrolytes,CT examination and other tests,improve the diagnosis and promptly take appropriate measures.