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一氧化碳中毒中的神经精神障碍及危险因素

Neuropsychiatric disorders and risk factors in carbon monoxide intoxication.

作者信息

Katirci Yavuz, Kandis Hayati, Aslan Sahin, Kirpinar Ismet

机构信息

Ankara Teaching and Research Hospital, Emergency Medicine, Ankara, Turkey.

出版信息

Toxicol Ind Health. 2011 Jun;27(5):397-406. doi: 10.1177/0748233710387632. Epub 2010 Nov 18.

Abstract

Neuropsychiatric sequelae may be observed in the late phases of carbon monoxide (CO) intoxication. Establishing a link between CO-related neuropsychiatric disorders and associated risk factors may decrease morbidity and mortality by means of appropriate treatment and counseling. The aim of the present study was to determine the relationship between neuropsychiatric outcomes of CO intoxication and demographic and clinical variables. Thirty patients who presented with CO intoxication and had no known neuropsychiatric disease, and 30 healthy controls were included. Physical examinations and laboratory tests were performed. Following the 1st therapy, they underwent mental and psychiatric tests 5 times (the time of discharge, during the 1st week, and during the 1st, 3rd, and 6th months). They underwent cerebral magnetic resonance imaging (MRI) at the end of the 1st month. They were evaluated by cognitive function tests at the 6th month. Lesions relevant to CO intoxication were detected in 46.7% of the patients via cranial computed tomography and in 13.3% via MRI. Evaluation of psychiatric tests revealed a clear decrease in cognitive functions, such as immediate memory, learning, reaching the criterion, spontaneous recall, attention, visual memory, and logical memory. It was found that the patients had anxiety within the 1st month, and the frequency of anxiety reached to the value of the control group by the end of the 6th month. In conclusion, we suggested that CO intoxication might lead to neuropsychiatric disorders. Our results emphasized that in addition to standard treatment, neuropsychiatric evaluation should also be performed in patients with CO intoxication.

摘要

一氧化碳(CO)中毒后期可能会出现神经精神后遗症。确定与CO相关的神经精神障碍及其相关危险因素之间的联系,可能通过适当的治疗和咨询来降低发病率和死亡率。本研究的目的是确定CO中毒的神经精神后果与人口统计学和临床变量之间的关系。纳入了30例出现CO中毒且无已知神经精神疾病的患者以及30名健康对照者。进行了体格检查和实验室检查。在首次治疗后,他们接受了5次心理和精神测试(出院时、第1周、第1、3和6个月)。在第1个月末进行了脑磁共振成像(MRI)检查。在第6个月通过认知功能测试对他们进行评估。通过头颅计算机断层扫描在46.7%的患者中检测到了与CO中毒相关的病变,通过MRI检测到的比例为13.3%。精神测试评估显示,即时记忆、学习、达到标准、自发回忆、注意力、视觉记忆和逻辑记忆等认知功能明显下降。发现患者在第1个月内存在焦虑情绪,到第6个月末焦虑频率达到对照组水平。总之,我们认为CO中毒可能导致神经精神障碍。我们的结果强调,除了标准治疗外,对CO中毒患者还应进行神经精神评估。

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