急性一氧化碳中毒迟发性神经精神后遗症危险因素分析

Abstract
Figure/Table
References (20)
Related Citation (15)

Download: PDF (583 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To analysis the risk factors on delayed neuropsychiatric sequelae (DNS) after acute carbon monoxide poisoning (ACMP). Methods from February 2013 to March 2016, in Department of Hyperbaric Oxygen and ER, the clinical data of 119 patients diagnosed as ACMP were retrospectively analyzed. Patients were divided into DNS group (15 cases) and non-DNS group (104 cases), they occured DNS or not after poisoning 5 weeks. The factors might affect DNS development including gender,age,duration of exposure,disturbance of consciousness,if or not receiving HBOT within 24 hours after poisoning and white blood cell count (WBC), creatine kinase (CK), creatine kinase isoenzymes (CK-Mb) in vein serums were compared. Results The univariate analysis results showed: duration of exposur ≥ 6 hours, glasgow coma scale (GCS) score < 9 and insufficient HBOT within 24 h after poisoning were related with DNS development (P < 0.05). The multivariate analysis showed: independent prognostic factors were GCS score < 9 (OR = 1.05, 95%CI: 1.01-1.09) and age (OR = 5.83, 95%CI: 1.13-25.58) (P < 0.05). Conclusion ACMP patients who is elder, more serious disturbance of consciousness, has longer period of exposure and insufficient HBOT within 24 h after poisoning are likely to develop DNS. More attentions should be paid to these patients who have such characteristics.

Key words： Acute carbon monoxide poisoning Delayed neuropsychiatric sequelae Risk factors Hyperbaric oxygen

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Liang FU Le ZHANG Yu YANG Chen PANG Shuyi GUO Dazhi

Cite this article:

ZHANG Liang FU Le ZHANG Yu YANG Chen PANG Shuyi GUO Dazhi. Analysis of risk factors on delayed neuropsychiatric sequelae after acute carbon monoxide poisoning[J]. 中国医药导报, 2017, 14(14): 96-98,102.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I14/96

[1] 张微微，张熙，魏亚洲.一氧化碳中毒晚发脑病的病理及治疗探讨[J].北京军区医药，1999，11（5）：350-352.
[2] 叶任高，陆再英.内科学[M].6版.北京：人民卫生出版社，2004：971.
[3] Walker E，Hay A. Carbon monoxide poisoning [J]. Brit med，1999，319（7217）：1082-1083.
[4] Mathieu D，Mathieunoif M，Wathlel F. CO poisoning present aspects [J]. Bull Acad Natl Med，1996，180（5）：965-973.
[5] Pepe G，Castelli M，Nazerian P，et al. Delayed neuropsychological sequelae after carbon monoxide poisoning：predictive risk factors in the Emergency Department [J]. Scand J trauma Resusc Emerq Med，2011（19）：16.
[6] Buckley NA，Isbister GK， Stokes B，et al. Hyperbaric oxygen for carbon monoxide poisoning：a systematic review and critical analysis of the evidence [J]. Toxicol Rev，2005， 24（2）：75-92.
[7] Annane D，Chadda K，Gajdos P， et al. Hyperbaric oxygen therapy for acute domestic carbon monoxide poisoning：two randomized controlled trials [J]. Intensive Care Med，2011， 37（3）：486-492.
[8] Wolf SJ，Lavonas EJ，Sloan EP，et al. Clinical policy：critical issues in the management of adult patients presenting to the Emergency Department [J]. Ann Emerg Med，2008， 51（2）：138-152.
[9] Weaver LK. Clinical practice：carbon monoxide poisoning [J]. N Engl J Med，2009，360（12）：1217-1225.
[10] Weaver LK，Valentine KJ，Hopkins RO. Carbon monoxide poisoning：risk factors for cognitive sequelae and the role of hyperbaric oxygen [J]. Am J Respir Crit Care Med，2007，176（5）：491-497.
[11] Jason J，Rose，Xu Q，et al. Shining alight on carbon monoxide poisoning [J]. Am J Respir Crit Care Med，2015，192（10）：1145-1147.
[12] Lai C，Huang Y. Patients with carbon monoxide poisoning and subsequent dementia [J]. Medicine，2016，95（1）：2418.
[13] Zou J，Guo Q，Shao H，et al. Lack of pupil reflex and loss of consciousness predict 30-day neurological sequelae in patients with carbon monoxide poisoning [J]. PLoS One，2015，10（3）：119-126.
[14] Kitamoto T， Tsuda M，Kato M，et al. Risk factors for the delayed onset of neuropsychologic sequelae following carbon monoxide poisoning [J]. Acute Med Surg，2016，3（4）：315-319.
[15] Rukiye Unsal Sac，Medine Ay?拶in Ta?拶ar，■lknur Bostanci，et al. Characteristics of children with acute carbon monoxide poisoning in ankara：a single centre experience [J]. J Korean Med Sci，2015，30（12）：1836-1840.
[16] Kudo K，Otsuka K，Yagi J，et al.Predictors for delayed encephalopathy following acute carbon monoxide poisoning [J]. Emergency Mdeicine，2014，14（3）：1-7.
[17] 潘树义，潘晓雯，张禹，等.一氧化碳中毒和迟发性神经损害研究现状及对策[J].中华航海医学与高气压医学杂志，2009，16（6）：377-381.
[18] Hu H，Pan X，Wan Y，et al. Factors affecting the prognosis of patients with delayed encephalopathy after acute carbon monoxide poisoning [J]. Am J Emerq Med，2011， 29（3）：261-264.
[19] Thom SR，Bhopale VM，Fisher D，et al. Delayed neuropathology after carbon monoxide poisoning is immune-mediated [J]. Proc Natl Acad Sci USA，2004，101（37）：13660-13665.
[20] Thom SR，Bhopale VM，Han ST，et al. Intravascular neutrophil activation due to carbon monoxide poisoning [J]. Am J Respir Crit Care Med，2006，174（11）：1239-1248.