一氧化碳中毒迟发性脑病临床和MRI特点分析  

Clinical and MR imaging characteristics of patients with delayed encephalopathy after acute carbon monoxide poisoning

作　　者：丛树艳[1] 吕丹[2] 俭剑非[1] 赵秀兰[1] 

机构地区：[1]中国医科大学附属盛京医院神经内科,沈阳110003 [2]沈阳医学院沈洲医院神经内科,沈阳110042

出　　处：《中华神经医学杂志》2012年第5期512-515,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨急性一氧化碳（co）中毒迟发性脑病（DEACMP）的临床及MRJ特点。方法中国医科大学附属盛京医院神经内科自2007年1月至2011年7月共收治23例DEACMP患者，回顾性分析患者的临床表现、影像学资料。结果DEACMP临床症状主要为智能障碍（91.3％）、锥体外系损害（65．2％）及精神行为异常（52．2％）。MRI改变包括双侧皮质下白质和（或）侧脑室周围白质损害11例，双侧基底节（主要为双侧苍白球）损害4例，皮质下白质和（或）侧脑室周围白质与基底节同时受损害8例，其中单纯苍白球损害预后较好。均予高压氧、改善脑血循环药物、脑细胞营养药及对症治疗后，治疗总有效率为86．9％。结论头颅MRI检查对急性C0中毒后DEACMP的早期诊断、疗效观察和判定预后有重要的临床意义，及时足疗程的高压氧是重要和有效的治疗手段。Objective To discuss the clinical and MR imaging characteristics of patients with delayed encephalopathy after acute carbon monoxide （CO） poisoning （DEACMP）. Methods The clinical and imaging data of 23 patients with DEACMP, admitted to our hospital from January 2007 to July 2011, were retrospectively analyzed. Results The dominant symptoms of DEACMP included mentally falling in 21 patients （91.3%）, extrapyramidal impairments in 15 patients （65.2%）, and mental and behavioral abnormalities in 12 patients （52.2%）. Cranial MRI features included bilateral subcortical white matter and/or periventricular white matter damage in 11 patients, bilateral basal ganglia （mainly bilateral globus pallidus） damage in 4, and damage in both sub-cortical white matter and basal ganglia in 8. The prognosis of patients with simple globus pallidus damage was better. All patients were given high pressure oxygen, medications improving the cerebral blood circulation, brain nutritional medicine and symptomatic treatment with total efficiency reaching 86.9%. Conclusion Cranial MRI features has important values in early diagnosis, treatment efficacy evaluation and prognosis estimation of patients with acute DEACMP; full-time course of hyperbaric oxygen therapy is very important and effective.

关 键 词：一氧化碳中毒 迟发性脑病 临床特点 磁共振成像 

分 类 号：R595.1[医药卫生—内科学]