急性一氧化碳中毒迟发脑病34例临床分析

The clinical analysis of 34 cases acute carkon monxide intoxication delayed encephalopathy

目的:研究急性一氧化碳中毒迟发脑病的影响因素、临床表现和治疗方法,加深对这种疾病的认识。方法:回顾性分析自1995年至2001年以来收治的34例患者的临床资料。结果:急性一氧化碳中毒迟发脑病临床表现复杂多样,以痴呆、二便失禁、智能障碍为主,CT及MRI提示额、顶、颞、枕叶皮质下白质、半卵圆中心与脑室周围白质密度降低,两侧苍白球对称性类圆形低密度影,治疗主要是改善局部血液循环、改善脑细胞供氧、减轻血管内皮损伤。预后良好。结论:神经系统损害程度及预后与急性期吸入CO的浓度、昏迷时间长短、年龄、是否积极恰当治疗、既往身体状况、有无并发疾病等有关。

Objective To study the effect factor ,clinical situation,treatment of the carbon monoxide intoxication delayed en-cephalopathy,and to deepen the cognition of the disease.Method Collected and analyzed the clinical data of 34patients from1995to2001in hospital.Results The clinical situation is complicated and diversified.It includes amentia,incontinence,intel-lectual defect and other functional defect of nervous system.The CT and MRI show that the reduction of density in the white matter under cortex of the frontal lobe,vertex lobe,temporal and occipital lobes,low density in the centrum semiovale and circumference of the cerebral ventricles,para-round low density of amphipallidum which always is symmetric.The treatment is to improve the local blood circulation,increase oxygen supply of brain cells,decrease injury of vessels inhibiting demyelination,Conclusion The degree of the nervous system impairment.And the prognoses are related closely to the age,the time of the co-ma and concentration of the CO aspirated in the acute phase,also,not only related to the agents above but also to the active and appropriate treatment ,health history,complication or not.