摘要
目的:探讨并分析慢性阻塞性肺疾病急性加重期(AECOPD)伴意识障碍患者的临床特征。方法:选择江苏省南通市妇幼保健院急诊内科接诊的50例AECOPD伴意识障碍患者作为研究对象。对这些患者的病历资料进行回顾性研究,分析并总结其临床特征。结果:在这50例患者中,因合并有肺性脑病、低渗性脑病、脑梗死和药物相关性脑病而发生意识障碍的患者分别有26例、10例、8例和6例。其中,因合并有肺性脑病而发生意识障碍的患者其临床表现主要是睡眠颠倒、谵妄等;因合并有低渗性脑病而发生意识障碍的患者其临床表现主要是表情淡漠、昏迷及血钠水平降低等;因合并有脑梗死而发生意识障碍的患者其临床表现主要是头晕、头痛、失语、偏瘫、昏迷等;因合并有药物相关性脑病而发生意识障碍的患者其临床表现主要是谵妄、意识不清、昏迷等。这50例患者接受对症治疗后其中有2例患者死亡,其余48例患者的神志均恢复正常,其病情均得到不同程度的改善。结论:AECOPD伴意识障碍患者的发病机制较为复杂,主要与其发生肺性脑病、低渗性脑病、脑梗死和药物相关性脑病等有关,且其临床表现较为复杂。
Objective:To investigate and analyze the clinical characteristics of acute exacerbations of chronic obstructive pulmonary disease(AECOPD)with consciousness impairment.Methods:50 cases of AECOPD patients with consciousness disorder were selected as the study subjects.The medical records of these patients were retrospectively studied,and their clinical characteristics were analyzed and summarized.Results:Among the 50 patients,there were 26,10,8 and 6 patients with consciousness disorder due to pulmonary encephalopathy,hypoosmotic encephalopathy,cerebral infarction and drug-related encephalopathy.Among them,the clinical manifestations of patients with consciousness disorder due to the combination of pulmonary encephalopathy were mainly sleep inversion and delirium.The clinical manifestations of the patients with consciousness disorder due to the combination of hypotonic encephalopathy are indifference,coma and decrease of blood sodium level.The clinical manifestations of patients with consciousness disorder due to cerebral infarction are dizziness,headache,aphasia,hemiplegia,coma,etc.The main clinical manifestations of the patients with consciousness disorder due to the combination of medicine-related encephalopathy are delirium,unconsciousness and coma.Two of the 50 patients died after receiving symptomatic treatment,and the remaining 48 patients returned to normal consciousness with varying degrees of improvement in their condition.Conclusion:The pathogenesis of AECOPD patients with consciousness disorder is complex,mainly related to pulmonary encephalopathy,hypotonic encephalopathy,cerebral infarction and drug-related encephalopathy,and its clinical manifestations are complex.
作者
施伟华
SHI Weihua(Nantong Maternal and Child Health Hospital,Nantong 226001)
关键词
慢性阻塞性肺疾病
急性加重期
意识障碍
临床特征
chronic obstructive pulmonary disease
Acute exacerbation
Disturbance of consciousness
Clinical features
