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目的研究影响急性一氧化碳中毒发生迟发性脑病(DEACMP)的相关因素。方法选择沧州市人民医院急诊科收治的604例急性一氧化碳中毒患者,根据是否出现DEACMP分为DEACMP组和非DEACMP组,收集两组患者临床资料,分析影响DEACMP发生的相关因素。结果两组间患者年龄、饮酒史、基础疾病史、头颅影像学异常改变、持续昏迷时间、中毒程度和急性期并发症比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄>50岁(OR=4.615,95%CI:2.587~8.232)、有基础疾病史(OR=2.944,95%CI:1.676~5.173)、头颅影像学异常改变(OR=2.749,95%CI:1.567~4.822)、持续昏迷时间>6 h(OR=2.332,95%CI:1.338~4.064)和中毒程度重(中度,OR=71.52,95%CI:20.300~251.981;重度,OR=4.329,95%CI:2.392~7.833)是DEACMP发生的独立危险因素。结论应尽早针对高龄、有基础疾病、持续昏迷时间长、中毒程度重且头颅影像学有异常改变的一氧化碳中毒患者采取干预措施,防止DEACMP发生。
Objective To study the related factors that influence the occurrence of delayed encephalopathy (DEACMP) in acute carbon monoxide poisoning. Methods A total of 604 patients with acute carbon monoxide poisoning admitted to the emergency department of Cangzhou People’s Hospital were enrolled. According to whether DEACMP was divided into DEACMP group and non-DEACMP group, the clinical data of two groups were collected to analyze the related factors that influence the occurrence of DEACMP. Results There were significant differences in age, history of alcohol consumption, history of underlying diseases, abnormal craniosclerotic imaging, duration of coma, degree of poisoning and complication in acute phase between the two groups (P <0.05). Multivariate logistic regression analysis The results showed that there was a history of underlying diseases (OR = 2.944, 95% CI: 1.676-5.173) and abnormal head imaging (OR = 2.749, 95% CI, % CI: 1.567-4.822), continuous coma time> 6 h (OR = 2.332, 95% CI: 1.338-4.064) and severe poisoning (moderate, OR = 71.52, 95% CI: 20.300-251.981; = 4.329, 95% CI: 2.392 ~ 7.833) is an independent risk factor for DEACMP. Conclusion As soon as possible for the elderly, with underlying diseases, coma for a long time, severe degree of poisoning and head abnormalities in patients with carbon monoxide poisoning interventions to prevent DEACMP.