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患者,男,41岁,因煤气(CO)中毒后不省人事1小时被送入院。查H_3CO饱和度43％,即行高压氧治疗,神志较清醒,但感头痛,左侧肢体麻木,无力。查体:智力正常,无面、舌瘫,左偏身痛觉过敏。左侧肢体肌力Ⅳ级,腱反射(+++),Babinski’s征(±);右侧正常,腱反射(++),病理征(-)。内科情况正常。入院后继续行高压氧治疗,并给予脱水剂、能量合剂治疗,5天症状体征完全消失,颅脑CT未示异常。随诊半年无异常。 讨论 CO中毒迟发性脑病的发病率约占9％,多发生于中毒后的数天到数周。较重症病人急性期即可出
The patient, male, 41 years old, was admitted to hospital unconscious for 1 hour after gas (CO) poisoning. Check H_3CO saturation of 43%, that is, hyperbaric oxygen therapy, conscious more sober, but a sense of headache, left limb numbness, weakness. Physical examination: normal intelligence, no face, tongue paralysis, left hypersensitivity. Left limb muscle strength grade IV, tendon reflex (+++), Babinski’s sign (±); right normal, tendon reflex (++), pathological sign (-). Internal medicine is normal. After admission to continue hyperbaric oxygen therapy, and given dehydration agent, energy mixture therapy, 5 days symptoms and signs completely disappeared, CT showed no abnormal brain. Followed six months without exception. Discussion CO poisoning, the incidence of delayed encephalopathy accounted for about 9%, occurred in poisoning after a few days to several weeks. Severe cases of acute patients can be out