摘要
目的探讨急性一氧化碳中毒迟发性脑病(DEACMP)发生的危险因素。方法选取2013年至2018年本院收治的90例DEACMP患者作为病例组,按照1:2配对的病例对照研究方法,随机选取同期在本院神经内科、急诊科等治疗的未发生DEACMP的急性CO中毒患者180例作为对照组,对患者相关危险因素进行单因素及多因素分析。结果昏迷时间、中毒程度、合并基础疾病、颅脑CR/MRI检查结果与DEACMP的发生有关,昏迷时间≥4 h的患者发生DEACMP的风险是昏迷时间<4 h患者的6.9倍,重度中毒是中度的3.8倍,昏迷时间越长,中毒程度越深,DEACMP的发生率越高。患有基础疾病和头颅CT/MRI检查异常也是DEACMP发生的独立危险因素。结论应高度重视昏迷时间长、中毒程度深、颅脑影像学检查异常、合并基础疾病等危险因素的急性CO中毒患者,及时、早期、足疗程的高压氧治疗,以降低DEACMP的发生率。
Objective To explore the risk factors of the delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods 90 patients with DEACMP treated at our hospital from 2013 to 2018 were selected as case group.According to 1:2 matched case control study,180 patients with acute CO poisoning but with no DEACMP who were treated at the department of neurology and emergency room of our hospital during the same time period were randomly selected as a control group.The risk factors were analyzed by univariate and multivariate analyses.Results The coma time,poisoning degree,complication with underlying diseases,and the CR/MRI findings of the brain were related to the occurrence of DEACMP.The risk of DEACMP in the patients with coma≥4 h was 6.9 times that of those with coma<4 h;and the risk of the patients with severe poisoning was 3.8 times that of those with moderate;the longer the coma,the deeper the degree of poisoning,and the higher the incidence of DEACMP.Having underlying disease and abnormalities in head CT/MRI were also independent risk factors of DEACMP.Conclusions Patients with acute CO poisoning who have a long period of coma,deep poisoning,abnormal brain imaging,and underlying diseases should be highly valued.Hyperbaric oxygen therapy in a timely,early,and full course of treatment should be taken to reduce the incidence of DEACMP.
作者
宋爱华
高德朋
Song Aihua;Gao Depeng(Department of Public Health,Weihai Central Hospital,Weihai 26440,China)
出处
《国际医药卫生导报》
2020年第2期233-235,共3页
International Medicine and Health Guidance News
关键词
一氧化碳中毒
迟发性脑病
危险因素
Carbon monoxide poisoning
Delayed encephalopathy
Risk factors
