| ObjectiveCarbon monoxide is the most common suffocating gas, and the death toll causedby ACMP is still on the top of the list of the death toll of all kinds of acuteintoxication around the world. After the latent phase ranging from days to weeks,10to40percent of the patients of ACMP may suffer from DEP, which is difficult andrequire a long time to treat thus brings heavy burden to family and the society. Thisresearch analyzes clinical feature and therapeutic process of230ACMP patients thatare treated in Shenyang9thhospital. The correlations between the occurrence of DEPand elements including sex, age, occupation, the time of duration, the degree ofintoxication, the time of hyperbaric oxygen therapy, whether the patient hascardiovascular and cerebrovascular diseases before intoxication, whethercomplications occur during acute stage are discussed. The change of EEG and CTbefore and after therapy is observed, and the application value of EEG and CT inACMP and DEP is studied. This research supplies gist for the early diagnosis,judgment prognosis, directed therapy and precaution for ACMP and DEP.Observation Object and Methods1.Cases selectionSelect230cases of ACMP that are treated in Shenyang9thHospital from2007.1to2011.12, including130cases of male patients and100cases of female patients.Group the cases into73cases of DEACMP and157cases of non-DEACMPaccording to whether DEP occurred. The diagnosis of ACMP and DEACMP is basedon GBZ23-2002.2.Survey indexGather the change of the state of illness in the period of morbidity, therapy andrecovery in12months after leaving hospital. All the information of patients, including sex, age, occupation, degree of education, medical history of Cardia-cerebrovascularDisease, the length of coma, concentration of COHb, the severity of intoxication,whether complications occur during acute stage are gathered through medical record,follow-up data, EEG and CT.3. Statistical methodsCollected data after investigation,selected SPSS l3.0statistical software, chooseχ2test in many groups comparisons,choose chi-square test counting material toproceed statistics theory, significance level α≤0.05.ResultsAccording to the cases that are observed, the morbidity of DEACMP is of thesame(p>0.05) among patients of different age and sex.Patients with medical historyof Cardia-cerebrovascular Disease and patients with complication have highermorbidity of DEACMP. Patients who coma for longer time also have highermorbidity of DEACMP (p<0.05). Patients who suffer more severe degree ofintoxication are more likely to suffer DEACMP (p<0.05). Hyperbaric oxygen therapycan’t prevent DEACMP from happening.This phenomenon is obvious in frontal part or frontotemporal, and is usuallypersistent. Flat waves appear in severe cases, and in particular cases sharp wave orspike waves appear. The severity of change in EEG is directly proportional to theseverity of intoxication. Change in CT mainly appears to be the density of brainprotein and basal ganglia pallidum becomes less in both sides of the brain.Encephalatrophy happens in a small number of cases. The change of CT doesn’tstrictly fit clinical symptoms. Encephlogram has a higher level of sensity while CThas a higher level of specificity by comparision.ConclusionAmong the objects of observation in this research, independent dangerouselements of DEP include severe intoxication, long time of coma and the lack ofhyperbaric oxygen therapy. Inducements of DEP include infectious fever, mentalstimulation, heavy drink and secondary poisoning. Dynamic observation of thechange of EEG and CT is of great value for the diagnosis of illness and the predictionof DEP. |
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