A Analysis For The Cause Of66Patients With Respiratory Diseases Combined With Disturbance Of Consciousness

Respiratory disease, especially chronic obstructive pulmonary disease, can causedisorder of consciousness. The disorder of consciousness is that people does not understandhimself and the surrounding environment. There are two types. One is excitability decreasedas sleepiness, awareness of fuzzy, lethargy until coma. The other is the increased excitability,which is a acute disorder of senior central, including disorientation, a disordered feeling,dysphoria and delirium, etc. With the aging population, the rate of basic diseases withdisturbance of consciousness is rising. The disorder of consciousness is a serious disease,and it is a important reason leading to died in the emergency treatment and ward. The key tocure the disease is that doctors understand the course of a disorder of consciousness. Butthere is a variety of reasons leading to a disorder of consciousness, especially the old, whohas other basic diseases at the same time, and they have not specific clinical manifestations.Therefore the early diagnosis and treatment is a great trouble. At present, there are morereports about the disorder of consciousness led by other system basic diseases. However,there is less reports about analysis for the cause of respiratory diseases with disturbance ofconsciousness. We can not distinguish the reasons which are the respiratory diseases, othersystem diseases or respiratory diseases with other system diseases. But respiratoryphysicians and emergency clinicians must face the problem, which is worth clinical doctorsto be studied and discussed.Objective: It would provide the causes of respiratory diseases with disturbance ofconsciousness by studying the clinical data, and it would provide favorable evidence for theclinical treatment via discussing the clinical characteristics of these diseases.Materials and Methods: In This study, it selected66patients with respiratory diseasecombined with disturbance of consciousness in ours hospital from January2010to January2012.32cases were female;66cases were male. The youngest was46years old; the oldestwas86years old. And the average age of66cases was (74.12±9.02) years old. By retrospectiveanalysis of these clinical data, distinguished the course of patients with respiratory diseasescombined with disturbance of consciousness.Results:1,In general: there were32(48.48%) women and34(51.52%)man. Theyoungest was46years old; the oldest was86years old.58(87.88%) case were not less than 65years old. They accounted for the main body of the respiratory diseases with disturbanceof consciousness.2, Cause:66cases of patients all had the clear cause. Among them62cases (62/66,93.9%) had a single cause, and4cases (4/66,6.1%) had duplex causes. Therewere a total of70cases of respiratory system disease with a disorder of consciousness.29(41.4%) cases were pulmonary encephalopathy, which was the main causes of therespiratory disease combined with disorder of consciousness.11(15.7%) cases were senilepneumonias.7(10.0%) cases were disorders of Water and electrolyte.5(7.1%) cases wereadverse drug reaction.4(5.7%) people were diagnosed cerebral infarction.4(5.7%) patientswere lung cancer with brain metastasis. There were4(5.7%) diagnosed diabetes, involving3patients with hypoglycemic coma and1person with hyperglycemic coma.2(2.9%) caseswere hypertensive encephalopathy. The last4cases were myocardial infarction, pulmonarythromboembolism, septic shock and upper gastrointestinal bleeding.The four cases ofpatients in duplex cases, one people both had the senile pneumonias and a disorder of Waterand electrolyte.One had pulmonary encephalopathy and a disorder of Water and electrolyte.A case had pulmonary encephalopathy and hypertensive encephalopathy, and one had senilepneumonias and diabetes.3, Prognosis and outcome: After treated the diseases leading to thedisturbance of consciousness and given a symptomatic and supportive treatment，52Patientswere cured and14cases were died. including11people with the single cause and3caseswith the duplex causes. the mortality of the single cause group was17.74%（11/62）and theduplex causes group was75%（3/4）.7cases were pulmonary encephalopathy.1people wereSenile pneumonia.1case was pulmonary thromboembolism.1cases was uppergastrointestinal bleeding. one people was lung cancer with brain metastasis.1patient wasdisorder of Water and electrolyte and senile pneumonias.1person was hyperglycemic comaand senile pneumonias. One case was pulmonary encephalopathy and disorder of Water andelectrolyte. The mortality between the single cause group and the duplex causes groupshowed significant difference(P﹤0.05).Conclusion:1, We find the common causes of respiratory diseases combined withdisturbance of consciousness are pulmonary encephalopathy, senile pneumonia, disorder ofWater and electrolyte, adverse drug reactions, cerebral infarction, lung cancer with brainmetastasis and diabetes.2,The elderly has more basic diseases and a high morbidity ofrespiratory diseases with disturbance of generally. Because the elderly have no typicalclinical manifestations, the diagnosis and treatment of diseases could be delayed, whichcould lead to the exacerbation of diseases or death. So we should closely observe the changes in condition, and see a doctor timely when the old people have a poor state. Weshould give systemic therapy in the early stages of the disease.3, We should Master theapplication of diuretics and related drugs and pay attention on diet and nursing to avoiddisorder of consciousness caused by iatrogenic factors.4, It is very important to distinguishreasons of respiratory diseases with disorder of consciousness that the patient completediagnostic examination including arterial blood gas, blood sugar, water and electrolyte, lungCT and head CT etc, and doctors complete asking medical history and physical examination.5,It is a key to a successful therapy that we can find the cause of disorder of consciousness.We must broaden our thinking facing patents with respiratory diseases combined withdisturbance of consciousness. We should not only consider the respiratory disease, but alsothink other system diseases.6,The mortality of the duplex causes group increasedsignificantly in comparison with the single cause group.