急性一氧化碳中毒后迟发性脑病继发癫痫患者临床特征及预后研究

发布时间：2018-03-07 15:05

本文选题：一氧化碳中毒　切入点：迟发性脑病　出处：《中国全科医学》2016年32期 　论文类型：期刊论文

【摘要】：背景既往研究对急性一氧化碳中毒后迟发性脑病(DEACMP)患者出现智能障碍、锥体外系神经功能障碍等症状关注较多,而对DEACMP继发癫痫的相关研究较少,因此探究DEACMP继发癫痫的发病率及其临床特点对临床中解决此类问题有很大帮助。目的分析DEACMP继发癫痫患者的临床特点,比较DEACMP继发癫痫与未继发癫痫患者的一般情况、治疗效果和预后的差别,为判断DEACMP继发癫痫患者的预后提供依据。方法 2001年1月—2014年1月新乡医学院第二附属医院、新乡医学院第一附属医院、新乡医学院第三附属医院、新乡市中心医院、新乡市第一人民医院、新乡市第二人民医院、中国人民解放军第371中心医院、河南宏力医院8家医院收治的450例DEACMP患者中,共272例患者符合入组与排除标准,通过门诊随访和电话随访,记录患者的病情变化、治疗效果、预后等。结果 272例患者中继发癫痫20例(7.4%),DEACMP发病后6个月内出现癫痫发作者17例(85.0%)。DEACMP继发癫痫与未继发癫痫患者性别、年龄、昏迷持续时间、假愈期比较,差异均无统计学意义(P0.05);DEACMP继发癫痫与未继发癫痫患者病情严重程度比较,差异有统计学意义(P0.05)。DEACMP继发癫痫与未继发癫痫患者疗效比较,差异有统计学意义(Z=5.098,P0.01)。DEACMP继发癫痫患者随访期间死亡12例,病死率为60.0%;DEACMP未继发癫痫患者死亡52例,病死率为20.6%;DEACMP继发癫痫与未继发癫痫患者病死率比较,差异有统计学意义(χ~2=15.95,P0.01)。结论 DEACMP继发癫痫患者具有病情严重程度重、治疗效果差、病死率高的特点,预防继发癫痫尤其是癫痫持续状态的发生对提高DEACMP患者的治疗效果和改善预后至关重要。
[Abstract]:Background previous studies have shown that patients with delayed encephalopathy (DEACMP) after acute carbon monoxide poisoning have developed mental retardation, and more attention has been paid to the symptoms of extrapyramidal neurological dysfunction, but there has been little research on epilepsy secondary to DEACMP. Therefore, to investigate the incidence and clinical characteristics of epilepsy secondary to DEACMP is of great help in solving such problems. Objective to analyze the clinical characteristics of patients with epilepsy secondary to DEACMP and to compare the general situation of patients with epilepsy secondary to and without DEACMP. Methods from January 2001 to January 2014, the second affiliated Hospital of Xinxiang Medical College, the first affiliated Hospital of Xinxiang Medical College, the third affiliated Hospital of Xinxiang Medical College, the third affiliated Hospital of Xinxiang Medical College, the second affiliated Hospital of Xinxiang Medical College, and the third affiliated Hospital of Xinxiang Medical College. Of the 450 DEACMP patients treated in Xinxiang Central Hospital, Xinxiang first people's Hospital, Xinxiang second people's Hospital, the 371st Central Hospital of the Chinese people's Liberation Army and 8 hospitals of Henan Hongli Hospital, a total of 272 patients met the criteria for admission and exclusion. Through outpatient follow-up and telephone follow-up, the changes of the patient's condition and the effect of treatment were recorded. Results among 272 cases, 20 cases of secondary epilepsy occurred within 6 months after the onset of DEACMP. 17 cases with secondary epilepsy were compared with those without secondary epilepsy, such as sex, age, duration of coma, pseudo recovery period, sex, age, duration of coma. There was no significant difference between DEACMP and non-epileptic patients, and there was significant difference in the curative effect of DEACMP between the patients with secondary epilepsy and non-epileptic patients, there was no significant difference between DEACMP and non-epileptic patients, and there was no significant difference between DEACMP patients with secondary epilepsy and non-epileptic patients with DEACMP. The difference was statistically significant in 12 patients with secondary epilepsy and 52 patients with no secondary epilepsy. The mortality rate was 20.6DEACMP, and the mortality was 20.6DEACMP secondary epilepsy and non-secondary epilepsy. The difference was statistically significant (蠂 2 + 15.95% P 0.01). Conclusion patients with epilepsy secondary to DEACMP have the characteristics of severe condition, poor therapeutic effect and high mortality. The prevention of secondary epilepsy, especially the occurrence of epileptic status, is very important to improve the therapeutic effect and improve the prognosis of patients with DEACMP.
【作者单位】：新乡医学院第二附属医院;新乡市中心医院;中国人民解放军第371中心医院;新乡医学院第一附属医院;新乡医学院第三附属医院;新乡市第一人民医院;沁阳市人民医院;武陟县人民医院;
【基金】：国家自然科学基金资助项目(81671319) 河南省科技厅科技攻关计划资助项目(0624410035)
【分类号】：R595.1;R747.9

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