CAJ | 학술논문

目的探讨急性一氧化碳(CO)中毒迟发性脑病(DEACMP)的临床及MRI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CO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.
목적 탐토급성일양화탄(CO)중독지발성뇌병(DEACMP)적림상급MRI특점. 방법 중국의과대학부속성경의원신경내과자2007년1월지2011년7월공수치23례DEACMP환자,회고성분석환자적림상표현、영상학자료. 결과 DEACMP림상증상주요위지능장애(91.3％)、추체외계손해(65.2％)급정신행위이상(52.2％).MRI개변포괄쌍측피질하백질화(혹)측뇌실주위백질손해11례,쌍측기저절(주요위쌍측창백구)손해4례,피질하백질화(혹)측뇌실주위백질여기저절동시수손해8례,기중단순창백구손해예후교호.균여고압양、개선뇌혈순배약물、뇌세포영양약급대증치료후,치료총유효솔위86.9％. 결론 두로MRI검사대급성CO중독후DEACMP적조기진단、료효관찰화판정예후유중요적림상의의,급시족료정적고압양시중요화유효적치료수단.
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.