本文選題：一氧化碳中毒　切入點(diǎn)：遲發(fā)性腦病　出處：《中國(guó)全科醫(yī)學(xué)》2016年32期 　論文類型：期刊論文

【摘要】：背景既往研究對(duì)急性一氧化碳中毒后遲發(fā)性腦病(DEACMP)患者出現(xiàn)智能障礙、錐體外系神經(jīng)功能障礙等癥狀關(guān)注較多,而對(duì)DEACMP繼發(fā)癲癇的相關(guān)研究較少,因此探究DEACMP繼發(fā)癲癇的發(fā)病率及其臨床特點(diǎn)對(duì)臨床中解決此類問題有很大幫助。目的分析DEACMP繼發(fā)癲癇患者的臨床特點(diǎn),比較DEACMP繼發(fā)癲癇與未繼發(fā)癲癇患者的一般情況、治療效果和預(yù)后的差別,為判斷DEACMP繼發(fā)癲癇患者的預(yù)后提供依據(jù)。方法 2001年1月—2014年1月新鄉(xiāng)醫(yī)學(xué)院第二附屬醫(yī)院、新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院、新鄉(xiāng)醫(yī)學(xué)院第三附屬醫(yī)院、新鄉(xiāng)市中心醫(yī)院、新鄉(xiāng)市第一人民醫(yī)院、新鄉(xiāng)市第二人民醫(yī)院、中國(guó)人民解放軍第371中心醫(yī)院、河南宏力醫(yī)院8家醫(yī)院收治的450例DEACMP患者中,共272例患者符合入組與排除標(biāo)準(zhǔn),通過門診隨訪和電話隨訪,記錄患者的病情變化、治療效果、預(yù)后等。結(jié)果 272例患者中繼發(fā)癲癇20例(7.4%),DEACMP發(fā)病后6個(gè)月內(nèi)出現(xiàn)癲癇發(fā)作者17例(85.0%)。DEACMP繼發(fā)癲癇與未繼發(fā)癲癇患者性別、年齡、昏迷持續(xù)時(shí)間、假愈期比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);DEACMP繼發(fā)癲癇與未繼發(fā)癲癇患者病情嚴(yán)重程度比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。DEACMP繼發(fā)癲癇與未繼發(fā)癲癇患者療效比較,差異有統(tǒng)計(jì)學(xué)意義(Z=5.098,P0.01)。DEACMP繼發(fā)癲癇患者隨訪期間死亡12例,病死率為60.0%;DEACMP未繼發(fā)癲癇患者死亡52例,病死率為20.6%;DEACMP繼發(fā)癲癇與未繼發(fā)癲癇患者病死率比較,差異有統(tǒng)計(jì)學(xué)意義(χ~2=15.95,P0.01)。結(jié)論 DEACMP繼發(fā)癲癇患者具有病情嚴(yán)重程度重、治療效果差、病死率高的特點(diǎn),預(yù)防繼發(fā)癲癇尤其是癲癇持續(xù)狀態(tài)的發(fā)生對(duì)提高DEACMP患者的治療效果和改善預(yù)后至關(guān)重要。
[Abstract]:Background previous studies have shown that patients with delayed encephalopathy (DEACMP) after acute carbon monoxide poisoning have developed mental retardation, and more attention has been paid to the symptoms of extrapyramidal neurological dysfunction, but there has been little research on epilepsy secondary to DEACMP. Therefore, to investigate the incidence and clinical characteristics of epilepsy secondary to DEACMP is of great help in solving such problems. Objective to analyze the clinical characteristics of patients with epilepsy secondary to DEACMP and to compare the general situation of patients with epilepsy secondary to and without DEACMP. Methods from January 2001 to January 2014, the second affiliated Hospital of Xinxiang Medical College, the first affiliated Hospital of Xinxiang Medical College, the third affiliated Hospital of Xinxiang Medical College, the third affiliated Hospital of Xinxiang Medical College, the second affiliated Hospital of Xinxiang Medical College, and the third affiliated Hospital of Xinxiang Medical College. Of the 450 DEACMP patients treated in Xinxiang Central Hospital, Xinxiang first people's Hospital, Xinxiang second people's Hospital, the 371st Central Hospital of the Chinese people's Liberation Army and 8 hospitals of Henan Hongli Hospital, a total of 272 patients met the criteria for admission and exclusion. Through outpatient follow-up and telephone follow-up, the changes of the patient's condition and the effect of treatment were recorded. Results among 272 cases, 20 cases of secondary epilepsy occurred within 6 months after the onset of DEACMP. 17 cases with secondary epilepsy were compared with those without secondary epilepsy, such as sex, age, duration of coma, pseudo recovery period, sex, age, duration of coma. There was no significant difference between DEACMP and non-epileptic patients, and there was significant difference in the curative effect of DEACMP between the patients with secondary epilepsy and non-epileptic patients, there was no significant difference between DEACMP and non-epileptic patients, and there was no significant difference between DEACMP patients with secondary epilepsy and non-epileptic patients with DEACMP. The difference was statistically significant in 12 patients with secondary epilepsy and 52 patients with no secondary epilepsy. The mortality rate was 20.6DEACMP, and the mortality was 20.6DEACMP secondary epilepsy and non-secondary epilepsy. The difference was statistically significant (蠂 2 + 15.95% P 0.01). Conclusion patients with epilepsy secondary to DEACMP have the characteristics of severe condition, poor therapeutic effect and high mortality. The prevention of secondary epilepsy, especially the occurrence of epileptic status, is very important to improve the therapeutic effect and improve the prognosis of patients with DEACMP.
【作者單位】： 新鄉(xiāng)醫(yī)學(xué)院第二附屬醫(yī)院;新鄉(xiāng)市中心醫(yī)院;中國(guó)人民解放軍第371中心醫(yī)院;新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院;新鄉(xiāng)醫(yī)學(xué)院第三附屬醫(yī)院;新鄉(xiāng)市第一人民醫(yī)院;沁陽市人民醫(yī)院;武陟縣人民醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(81671319) 河南省科技廳科技攻關(guān)計(jì)劃資助項(xiàng)目(0624410035)
【分類號(hào)】：R595.1;R747.9

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