CAJ | 학술논문

目的：收集广西部分医院急性一氧化碳中毒后迟发性脑病（ DEACMP）患者的临床资料，分析影响DEACMP预后的因素。方法回顾分析2008～2014年广西武鸣县人民医院、广西区人民医院、广西区江滨医院住院的52例DEACMP患者的临床资料，病后3个月根据患者日常生活能力量表（ ADL）的评分结果分为无效组25例和好转组27例，分别比较两组患者性别、年龄、基础疾病、暴露在CO中的时间、昏迷时间、假愈期、急性期是否高压氧（ HBO）治疗、并发症、早期头颅CT、MRI是否异常、入院时心肌酶谱、心电图、血白细胞总数是否异常、入院时ADL评分以及是否使用依达拉奉15项可能影响DEACMP预后的因素。结果年龄、暴露在CO中的时间、假愈期、急性期是否行HBO治疗、并发症、早期头颅MRI是否异常、入院时ADL评分与DEACMP患者预后相关（ P＜0.05），其中年龄、暴露在CO中的时间、入院时ADL评分意义更大（ P＜0.01），而其余因素对DEACMP患者预后无明显影响（P＞0.05）。结论年龄较大、暴露在CO中的时间长、假愈期较短、急性期未行HBO治疗、早期头颅MRI异常、并发症以及入院时ADL评分较低均提示DEACMP患者预后差，应高度警惕。
목적：수집엄서부분의원급성일양화탄중독후지발성뇌병（ DEACMP）환자적림상자료，분석영향DEACMP예후적인소。방법회고분석2008～2014년엄서무명현인민의원、엄서구인민의원、엄서구강빈의원주원적52례DEACMP환자적림상자료，병후3개월근거환자일상생활능역량표（ ADL）적평분결과분위무효조25례화호전조27례，분별비교량조환자성별、년령、기출질병、폭로재CO중적시간、혼미시간、가유기、급성기시부고압양（ HBO）치료、병발증、조기두로CT、MRI시부이상、입원시심기매보、심전도、혈백세포총수시부이상、입원시ADL평분이급시부사용의체랍봉15항가능영향DEACMP예후적인소。결과년령、폭로재CO중적시간、가유기、급성기시부행HBO치료、병발증、조기두로MRI시부이상、입원시ADL평분여DEACMP환자예후상관（ P＜0.05），기중년령、폭로재CO중적시간、입원시ADL평분의의경대（ P＜0.01），이기여인소대DEACMP환자예후무명현영향（P＞0.05）。결론년령교대、폭로재CO중적시간장、가유기교단、급성기미행HBO치료、조기두로MRI이상、병발증이급입원시ADL평분교저균제시DEACMP환자예후차，응고도경척。
Objective To analyze the factors affecting the prognosis in patients with delayed encephalopathy after acute carbon monoxide poisoning( DEACMP) .Methods Fifty-two DEACMP cases were collected from the people′s hospital of Wuming county, the people′s hospital of Guangxi Zhuang Autonomous region and the Jiangbin hospital of Guangxi Zhuang Autonomous region from 2008 to 2014 and were retrospectively studied.According to the results of pa-tients′daily life ability scale(ADL) scores 3 months after the illness, the patients were divided into non-improvement group(n=25) and improvement group(n=27) on the basis of their recovery progress.The factors affecting the progno-sis of DEACMP patients including gender, age, primary diseases, exposure time within the CO, unconsciousness dura-tion, pseudo-recovery period Hyperbaric oxygen(HBO) treatment in acute phase, brain magnatic resonance imaging ( MRI) scan, daily life ability scale( ADL) score on admission, and use of Edaravone were compared between the two groups.Results Age, exposure time within the CO, pseudo-recovery period, HBO treatment in acute stag, complica-tions, abnormal in early brain MRI scan and the higest ADL scores were related to the prognosis of DEACMP patients (P<0.05).Other factors such as gender, primary diseases, unconsciousness duration, brain CT scan, edaravone had no significantly differences(P>0.05).Conclusion Aging, complications, long time exposure to CO, shorter pseudo-recovery period, HBO treatment in acute stag, abnormal in early brain MRI scan and lower ADL scores indicate poor prognosis in DEACMP patients.More attentions should be paid to the treatment of patients who have these disorders.