慢性阻塞性肺疾病急性加重期意识障碍的病因构成分析

Analysis Consciousness Disorder Etiology Constitute of Chronic Obstructive Pulmonary Disease Acute Exacerbation Period

目的探讨引起慢性阻塞性肺疾病(COPD)急性加重期意识障碍的病因构成。方法回顾性分析COPD急性加重期意识障碍60例患者的临床资料,探讨引起意识障碍的原因。结果肺性脑病31例(51.67%):早期出现神志恍惚、兴奋多语,继而出现谵妄、躁动、肌肉抽动、昏迷等,动脉血气PaCO2明显升高等;低渗性脑病19例(31.67%):头痛、口渴、表情淡漠、幻觉、抽搐、昏迷,血电解质紊乱等;脑梗死6例(10.00%):意识改变外,有偏瘫、失语等,头颅CT、MRI异常等;药物不良反应4例(6.67%):兴奋、欣快、情感改变等,有相关药物应用史。结论 COPD急性加重期合并意识障碍病因多,表现既有相同又各有特点,临床上通过询问病史及体格检查,及时完善电解质、动脉血气等检查,必要时并需行CT检查等可基本明确诊断。

Objective Explore cause chronic obstructive pulmonary disease（COPD）acute exacerbation period consciousness disorder etiology constitutes. Methods Retrospective analysis of COPD patients with acute exacerbations consciousness obstacle period of 50 patients with clinical data,we discussed the reason caused （51.67% ） ： early a trance obstacle. Results Pulmonary encephalopathy 31 eases , excited multilingual, and then there delirium,agitated,muscle Twitch, coma, arterial blood gas PaCO2 increased significantly; etc. Low permeability encephalopathy 19 patients （31.67%） ：headaches,thirsty,expressionlndifference,illusion, convulsions, coma, blood electrolytes disturbance, etc; Cerebral infarction in 6 cases （10.00%） ： besides consciousness change outside, biasedParalyzed, aphasia, head CT, MRI abnormalities, Adverse drug reactions 4 cases（6.67%）： excited, article, emotional change etc, Relat- ed drugs apphcation history. Conclusion COPD acute exacerbation period cause disorder of consciousness,both the same performance and have different features. By asking the clinical history and physical examination,consummate electrolyte,arterial blood gas examination such as and when necessary,take to do CT etc Basic clear diagnosis.