一氧化碳中毒迟发性脑病的临床研究  

A clinical study on delayed encephalopathy after carbon monoxide poisoning

作　　者：余海[1] 潘晓雯[1] 孟娟[1] 丁建章[1] 徐光华[1] 房广才[1] 

机构地区：[1]海军总医院高压氧科,北京100037

出　　处：《中华劳动卫生职业病杂志》2002年第1期26-28,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的　研究CO中毒迟发性脑病 (DEACMP)的临床与影像学特征 ,及其与病程、预后的关系。方法　对 198例DEACMP患者的假愈期、临床表现、病程、预后 ,以及头部CT、MRI、SPECT所见进行对比分析。结果　本组病例中 ,30d内病情开始好转者占 6 0 .1%,31～ 6 0d者占 2 3.7%,>6 0d者占 14.6 %,总临床治愈率为 32 .8%,有效率为 70 .1%;依据影像学所见 ,脑损害部位为双侧基底节者占 15 .2 %,皮质下白质损害者为 70 .0 %,两种损害同时存在者为 12 .6 %,无异常改变者 2 .1%;其发病至病情好转分别为 (4 4.6± 10 .1)、(38.2± 11.9)、(6 1.3± 17.0 )、(7.5± 2 .4)d。影像学所见能反映脑损害程度 ,但与临床改善不平行 ,SPECT更能反映病情改善情况。结论　DEACMP与缺血性脑损害有关 ,其病程具有显著的自限性。Objective To investigate clinical and imaging characteristics of delayed encephalopathy after carbon monoxide poisoning(DEACMP). Mehtods A retrospective and comparative analysis of neurological manifestations,course,periods of false-cure,prognosis and neuroimaging findings were conducted in 198 patients with DEACMP. Results Of these patients,60.1% obtained an initial recovery within 30 d,23.7% within 31～60 d and 14.6% over 60 d.Total clinical rate was 32.8%,and effectiveness rate 70.1%.According to imaging findings,15.2% patients were found to have bilateral lesions of basal ganglion,and 70.0% with lesions of subcortical white matter,12.6% with lesions of two types above mentioned and 2.1% with no lesions.The intervals between onset of illness and initial recovery were (44.6±10.1), (38.2±11.9),(61.3±17.0)d,and (7.5±2.4)d respectively.Imaging findings can demonstrate the severity of brain injury,but not necessarily parallel to the improvement of illness,for which SPECT proves more useful. Conclusions DEACMP is involved in ischemic brain injury and a self-limited illness.

关 键 词：一氧化碳中毒 迟发性脑病 高压氧 影像学特征 临床研究 缺血性脑损害 

分 类 号：R595.1[医药卫生—内科学] R749.63[医药卫生—临床医学]