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目的探讨急性一氧化碳中毒后迟发性脑病(DEACMP)发病的相关危险因素。方法以2001—2014年在豫北地区10家医院符合入组标准和排除标准的急性一氧化碳中毒(ACMP)752例住院患者为研究对象,收集临床资料,并随访90d以上,根据以后是否发生DEACMP分为ACMP组和DEACMP组,对所有患者的年龄、昏迷时间、昏迷程度、吸烟饮酒史等26个指标进行统计归纳,分析ACMP后患者发生DEACMP的可能危险因素。结果 752例ACMP患者中127例发生DEACMP,发生率16.9%。单因素分析结果显示,ACMP患者男性较女性更易患DEACMP,差异有统计学意义(P<0.05);昏迷时间>12h者DEACMP发生率明显升高,>48h者58.3%发生DEACMP;中度以上昏迷、病理征阳性、丧偶、吸烟史、饮酒史、重大精神刺激等患者发生DEACMP风险大于无此类病史者,差异均有统计学意义(P<0.05);ACMP急性期颅脑CT异常、并存其他疾病其DEACMP发生率较高,差异有统计学意义(P<0.05)。多因素回归分析显示,性别、丧偶、头颅CT异常、昏迷程度、昏迷时间是发生DEACMP的独立危险因素。结论发生DEACMP的危险因素较多,尤其对40岁以上、男性、有丧偶史、头颅CT异常、中度昏迷以上、昏迷时间>12h的ACMP患者应特别注意加强临床监测,提前采取干预措施给予病前预防性治疗。
Objective To explore the related risk factors of delayed encephalopathy (DEACMP) after acute carbon monoxide poisoning. Methods 752 inpatients with acute carbon monoxide poisoning (ACMP) in 10 hospitals in North Henan from 2001 to 2014 in our hospital were enrolled in this study. The clinical data were collected and followed up for more than 90 days. According to whether the DEACMP score For ACMP group and DEACMP group, 26 indicators such as age, coma time, coma and smoking and drinking history of all patients were statistically analyzed, and the possible risk factors of DEACMP in patients after ACMP were analyzed. Results Among the 752 cases of ACMP, 127 cases had DEACMP, the incidence rate was 16.9%. Univariate analysis showed that men with ACMP were more susceptible to DEACMP than women, the difference was statistically significant (P <0.05). The incidence of DEACMP was significantly higher in comatose patients> 12h and 58.3%> DEACMP in> 48h. , Pathological positive sign, widowed, smoking history, drinking history, major mental stimulation and other patients with DEACMP risk than those without such history, the differences were statistically significant (P <0.05); ACMP acute brain CT abnormalities co-exist other The incidence of DEACMP in the disease was higher, the difference was statistically significant (P <0.05). Multivariate regression analysis showed that sex, widowhood, CT abnormality, coma and coma were the independent risk factors of DEACMP. Conclusion There are many risk factors for DEACMP. Especially for those over 40 years old, male, with spouse history, head CT abnormality, moderate coma, coma> 12 hours, special attention should be paid to strengthen clinical monitoring and take interventions in advance Preventive treatment.