急性一氧化碳中毒发生迟发性脑病的相关因素分析

Analysis of Related Factors in Delayed Encephalopathy Caused by Acute Carbon Monoxide Poisoning

目的分析急性一氧化碳(CO)中毒患者发生迟发性脑病的相关因素分析。方法选取2020年1月至2022年8月葫芦岛地区177例符合急性CO中毒诊断的住院患者,回顾性分析纳入病例的临床资料,应用Spearman相关性分析与CO中毒迟发性脑病相关的影响因素。结果177例患者中男性91例(51.41%),发病年龄集中在60岁以上,共86例(48.59%);发病时间集中在凌晨4~8点,共42例(23.73%);地域主要集中在农村,共139例(78.53%);文化程度主要集中在初中及以下,共113例(63.84%);中毒方式以取暖方式不当为主,共107例(60.45%);中毒场所主要在家中,共132例(74.58%)。177例患者中死亡2例,发生一氧化碳中毒迟发性脑病患者18例(10.17%)。既往合并基础病(心血管病,高血压,糖尿病,脑梗死)、就诊时间、昏迷时间及早期出现脏器损害(包括急性肝损伤,急性肾损伤)与一氧化碳中毒迟发性脑病呈正相关,GCS评分与一氧化碳中毒迟发性脑病呈负相关。结论急性一氧化碳中毒主要集中在农村的老年人群,中毒原因主要由家中取暖方式错误,其中合并基础疾病(心血管病,高血压,糖尿病,脑梗死)、就诊时间及昏迷时间长,GCS评分低,早期出现脏器损害均与发生迟发性脑病相关,应早期识别迟发性脑病的高危患者,对其尽早进行干预治疗,提高治愈率,降低并发症。

Objective To analyze the analysis of factors related to the occurrence of delayed encephalopathy in patients with acute carbon monoxide(CO)poisoning.Methods A total of 177 hospitalized patients who met the diagnosis of acute CO poisoning in Huludao area from January 2020 to August 2022 were selected,and the clinical data of the included cases were retrospectively analyzed,and Spearman correlation analysis was applied to analyze the influencing factors related to delayed encephalopathy in CO poisoning.Results Among the 177 patients,91 cases(51.41%)were male,the age of onset was concentrated in the age of 60 years or above,totaling 86 cases(48.59%);the time of onset was concentrated in the morning from 4-8 AM,totaling 42 cases(23.73%);the geographic area was mainly concentrated in the rural area,totaling 139 cases(78.53%);and the education level was mainly concentrated in junior high school and below,totaling 113 cases(63.84%);The mode of poisoning was mainly inappropriate heating,107 cases(60.45%);the place of poisoning was mainly at home,132 cases(74.58%).2 cases died among 177 patients,and 18 cases(10.17%)of delayed encephalopathy in carbon monoxide poisoning occurred.Previous comorbidities(cardiovascular disease,hypertension,diabetes mellitus,cerebral infarction),the time of consultation,the time of coma,and the early organ damage(including acute liver,kidney injury)were positively correlated with delayed encephalopathy in carbon monoxide poisoning,and the GCS score was negatively correlated with delayed encephalopathy in carbon monoxide poisoning.Conclusions Acute carbon monoxide poisoning was mainly concentrated in the rural elderly,and the cause of poisoning was mainly due to the wrong way of heating at home,in which the combination of basic diseases,the time of consulting the doctor and the time of coma was long,the GCS score was low,and the early appearance of organ damage was related to the occurrence of delayed encephalopathy.