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一氧化碳中毒患者的人口学特征和迟发性神经后遗症危险因素。

Demographic characteristics and delayed neurological sequelae risk factors in carbon monoxide poisoning.

机构信息

Emergency Medicine Clinic, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.

Emergency Department, Maltepe University Faculty of Medicine, Istanbul, Turkey.

出版信息

Am J Emerg Med. 2020 Dec;38(12):2552-2556. doi: 10.1016/j.ajem.2019.12.037. Epub 2019 Dec 20.

DOI:10.1016/j.ajem.2019.12.037
PMID:31889577
Abstract

AIM

Carbon monoxide (CO) is a colorless, odorless gas and tasteless. CO poisoning (COP) is one of the most frequently encountered inhalation poisonings. The most common cause of morbidity in COP is delayed neurological sequelae (DNS). DNS is the occurrence of neuropsychiatric findings within 2-240 days after discharge of patients with COP and there are no definitive diagnostic criteria. The aim of our study is; to determine the risk factors and incidence of DNS.

METHOD

Our study is a retrospective, observational study. Patients with the diagnosis of COP in the emergency department between 2015 and 2016 were included in the study. Patients age, gender, findings in the initial physical examination (PE) and neurological examination (NE), blood carboxyhemoglobin (COHb) level, relation between hyperbaric oxygen (HBO) treatment and DNS were assessed.

RESULTS

Total of 72 patients were included in the study. Mean age was 33.43 ± 20.89. It was determined that pathological findings in the initial NE are a significant predictive factor for DNS (Odds ratio 18.600, p:0.004). Significant relation between NE and HBO treatment was present (p:00.1). There was no statistically significant relationship between initial COHb level and receiving HBO treatment (p:0.9). Median COHb level of patients with DNS was 30 (min:10, max: 43), median COHb level of patients without DNS was 25 (min:10, max:44) and there was no statistically significant relationship between the two groups according to COHb levels (p:0.7).

CONCLUSION

Pathological findings in the initial neurological examination had a predictive value for delayed neurological sequelae in patients with carbon monoxide poisoning.

摘要

目的

一氧化碳(CO)是一种无色、无味、无臭的气体。CO 中毒(COP)是最常见的吸入性中毒之一。COP 发病率最高的是迟发性神经后遗症(DNS)。DNS 是指 COP 患者出院后 2-240 天内出现神经精神发现,目前尚无明确的诊断标准。我们的研究目的是:确定 DNS 的危险因素和发病率。

方法

我们的研究是一项回顾性、观察性研究。研究纳入了 2015 年至 2016 年急诊科诊断为 COP 的患者。评估患者的年龄、性别、初始体检(PE)和神经系统检查(NE)的发现、血碳氧血红蛋白(COHb)水平、高压氧(HBO)治疗与 DNS 的关系。

结果

共有 72 例患者纳入研究。平均年龄为 33.43±20.89 岁。确定初始 NE 中的病理发现是 DNS 的一个显著预测因素(优势比 18.600,p:0.004)。NE 与 HBO 治疗之间存在显著关系(p:0.001)。初始 COHb 水平与 HBO 治疗之间无统计学显著关系(p:0.9)。DNS 患者的 COHb 中位数为 30(最小值:10,最大值:43),无 DNS 患者的 COHb 中位数为 25(最小值:10,最大值:44),两组根据 COHb 水平无统计学显著关系(p:0.7)。

结论

初始神经系统检查中的病理发现对 CO 中毒患者的迟发性神经后遗症有预测价值。

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