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目的:分析急性一氧化碳中毒导致迟发性脑病的发生机制和临床表现,探讨其综合治疗的方法和预后的影响因素。资料来源:应用计算机检索中国期刊全文数据库1983-01/2000-10和CBMdise相关文章。检索词“急性、一氧化碳中毒、迟发性、脑病”,限定文章语言种类为中文。资料选择:对资料进行初审,选取有关急性一氧化碳的发病机制、临床表现、治疗和预后的相关文章。纳入标准:①随机对照临床研究。②不限定盲法。排除标准:重复的同一研究。资料提炼:共收集到240篇关于急性一氧化碳中毒导致脑病的相关文献,24篇符合纳入标准。资料综合:急性一氧化碳中毒导致脑病的发病机制较为复杂,临床表现从症状、体征、脑电图、脑CT、磁共振方面来加深对该病的认识。治疗方法常采用:①神经细胞活化剂、血管扩张剂、抗凝剂及维生素。②高压氧。③紫外线照射充氧自血回输疗法。④针刺疗法。影响急性一氧化碳中毒后迟发性脑病预后的因素常与年龄、中毒程度、并发症及其救治的时间有关。结论:急性一氧化碳中毒可以导致脑病的发生,是多种机制共同作用的结果。目前尚无特异性的治疗方法,应采取综合治疗,但治疗效果不理想,可遗留不同程度的智力及肢体功能障碍,长期存在睁眼昏迷。
OBJECTIVE: To analyze the mechanism and clinical manifestation of delayed carbon monoxide poisoning in delayed encephalopathy, and to explore the methods and prognostic factors of its comprehensive treatment. Source: Applied Computer to Retrieve Chinese Journal Full-text Database 1983-01 / 2000-10 and CBMdise related articles. The term “acute, carbon monoxide poisoning, delayed, encephalopathy”, limited article language type is Chinese. Data Selection: Preliminary review of data, select articles about the pathogenesis of acute carbon monoxide, clinical manifestations, treatment and prognosis. Inclusion criteria: ① randomized controlled clinical studies. ② Not limited to blind method. Exclusion Criteria: Duplicate same study. DATA EXTRACTION: A total of 240 articles on encephalopathy caused by acute carbon monoxide poisoning were collected and 24 articles met the inclusion criteria. DATA SYNTHESIS: The pathogenesis of acute carbon monoxide poisoning leading to encephalopathy is more complicated. Clinical manifestations deepen the understanding of the disease in terms of symptoms, signs, EEG, brain CT, and magnetic resonance. Treatment methods are often used: ① nerve cell activators, vasodilators, anticoagulants and vitamins. ② hyperbaric oxygen. ③ UV irradiation oxygenation from blood transfusion therapy. ④ acupuncture therapy. The factors that affect the prognosis of delayed encephalopathy after acute carbon monoxide poisoning are often related to the age, the degree of poisoning, the complications and the time of its treatment. Conclusion: Acute carbon monoxide poisoning can lead to the occurrence of encephalopathy and is the result of multiple mechanisms. There is no specific treatment, should be taken comprehensive treatment, but the treatment is not satisfactory, can leave varying degrees of mental and physical dysfunction, long-term existence of open-eye coma.