일산화탄소 중독의 지연성 후유증에 관한 임상적 연구

CLINICAL STUDIES ON DELAYED SEQUELAE OF CARBON MONOXIDE INTOXICATION

A total of 43 patients admitted in Yonsei University Medical Centre with the diagnosis of delayed! sequelae of carbon monoxide intoxication was analyzed on their various clinical aspects in comparison with 50 control patients randomly selected from 374 patients who suffered from CO intoxication and admitted in Yonsei University Medical Centre. The incidence of delayed sequelae was rated as. 2.8% of acute CO intoxication, and tended to* increase in accordance with the age and the depth, of coma during acute intoxication. Concomitant illnesses which might affect patients’ cerebral or cardiorespiratory function such as hypertension or pulmonary tuberculosis were found in 44.2% of. delayed sequelae group, which: was significantly- higher than 24.0% of control group. The lucid interval of delayed sequelae was ranged from 3 to 47 days (m ean=20.3 days, S. D. = 9 .1 9 ), while hyperbaric oxygen therapy after acute intoxication appeared to make little difference on it. More than half of the case began to show their symptoms •during the third and the forth week after the -acute CO intoxication. First rank manifestations such as memory loss, double incontinence, dullness and apathy, mutism, hypokinesia and impairment of •orientation suggested their symptomatic uniqueness in striking contrast to wide symptomatic variety in other previous reports； in short, repidly deteriorating “hypokinetic mutism” after a lucid intervalof mental clarity was the rule in most cases. EEG findings showed mild to moderate abnormalities of diffuse slow activities； mixed delta and theta, which were nonspecific findings of metabolic or anoxic encephalopathy. The severer the clinical manifestation, the more delta waves tended to occur, although there was no evidence of linear correlation between the progress of clinical manifestation and EEG abnormality. Finally, the author was much impressed by a high improvement rate of 88.4% on discharge so long as sufficient admission period, say, more than a month, was given to the patients.