206例慢性肺心病合并意识障碍的临床观察分析

Analysis of clinical observation for 206 patients with chronic pulmonary heart disease complicating disturbance of consciousness

目的：分析慢性肺心病合并低渗性脑病原因并提出防治措施。方法：对１９９１～１９９６年在我院住院的肺心病合并意识障碍患者２０６例进行了回顾性调查。结果：１９９１～１９９３年收住肺心病合并意识障碍１０８例均诊断为“肺脑”，而忽略了低渗性脑病，死亡率为６２５％；１９９４～１９９６年共收住相同病人９８例，其中５２例患者发现合并低渗性脑病并采取相应措施，死亡５例，死亡率为５７％。二组病人死亡率有显著性差异（Ｐ＜００５）。结论：一部分肺心病合并意识障碍的病人与低渗性脑病相关，对这类病人要及早给予生化检测，并采取防治措施。

Objective: In order to investigate the causes of hypotonic encephalopathy in palients with corpulmonale and work out the preventive and the therapeutic strategies. Methods: 206 patients with chronic pulmonary heart disease (CPHD) complicating disturbance of consciousness were hospitalized at our hospital from 1991 to 1996 and their case data were reriewed. Results: In 19911993 group ,all the 108 patients with CPHD complicating disturbance of consciousness were diagnosed to be pulmonary encephalopathy and hypotonic encephalopathy was neglected. 30 of 48 patiens with hypotonic encephalopathy died form the misdiagnosed disease and the mortality was amount to 62.5%. In contrast to the former in 19941996 group, 52 patients with hypotonic encephalopathy were found in 98 patients and the therapeutic strategies were emplored correspondingly, as the results of which the mortality was 5.7%. The latter mortality was lower than that of former one (P<0005). Conclusion: Some patients with CPHD complicating disturbance of consciousness are involved in hypotonic encephalopathy and they should be given biochemical examination, blood gas analysis and some therapentis strategies shoule be taken as soon as possible