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脑病偶可发生于慢性呼吸功能不全病人的高碳酸血症治疗之后。这种脑病的表现包括多病灶性发作,全身性发作、轻度病灶性运动征及昏迷。以上体征可在治疗开始后数分钟至数日出现,过去认为是由于动脉内的CO_2分压迅速变化和伴发硷中毒所造成的。本文报道3例慢性阻塞性肺病伴发高碳酸血症经积极治疗后出现脑病的患者。这些病例的共同特点是在治疗过程中动脉内的CO_2分压迅速下降。可能造成脑的硷中毒,低血压及氨茶硷的使用则是造成这种脑病的附加因素,而脑缺血、脑低氧症和原有的结构性病灶可能与个体的敏感性有关。
Encephalopathy can occur even after hypercapnia in patients with chronic respiratory insufficiency. The manifestations of this encephalopathy include multiple focal episodes, generalized seizures, mild focal motor signs and coma. The above signs can appear in a few minutes to several days after the start of treatment, in the past that is due to rapid changes in intra-arterial CO 2 partial pressure and associated with alkaline poisoning caused. This article reports 3 patients with chronic obstructive pulmonary disease associated with hypercapnia after active treatment of patients with encephalopathy. A common feature of these cases is the rapid drop in intra-arterial CO 2 partial pressure during treatment. Brain alkalosis, hypotension, and theophylline use may be additional factors contributing to this encephalopathy, and cerebral ischemia, cerebral hypoxia, and preexisting structural lesions may be related to individual sensitivities.