| 일산화탄소 중독의 임상양상과 합병증 |
| 최선아, 최일생 |
| 연세대학교 의과대학 신경과학교실 |
| Clinical manifestations and complications in carbon monoxide intoxication |
| Sun Ah Choi,M.D., Il Saing Choi, M.D. |
| Department of Neurology, Yonsei University College of Medicine |
|
|
|
|
| Abstract |
|
Background ; Carbon Monoxide is colorless, ordorless, highly toxic gas produced by fire and by motor vehicles and appliances which use carbon-based fuels. In Korea, since coals were the main domestic fuel for cooking and for heating the floor, many cases of carbon monoxide intoxication have occurred annually. Until now, systemic complications & clinical manifestations as well as neurologic complications following carbon monoxide poisoning have rarely been reported. Methods ; I have researched systemic complications and clinical manifestations including neurologic complications from 1986 to 1997.
I reviewed retrospectively medical records of 188 admitted patients to the
Yonsei Medical Center due to carbon monoxide intoxication, and analyzed them
according to the neurological, cardiovascular, respiratory, urogenital,
dermatological and other systems. Results ; 1)The number of the admitted
patients due to CO intoxication to Yonsei Medical Center between 1986 and 1997
has decreased compared to that between 1976 and 1981. 2)In this study, the
cause of CO intoxication were furnaces in 170 cases(93.9%), fire accidents in 2
cases(1.1%), gas boilers in 2 cases(1.1%), LPG gas in 1 case(0.55%) and propan
gas in 1 case(0.55%) in order. 3)Systemic complications and clinical
manifestations after CO intoxication were 167(88.8%) nervous , 59(31.4%)
musculoskeletal, 56(29.8%) respiratory, 49(26%) dermatologic, 44(23.4%)
cardiovascular, 30(16.0%) genitourinary and 9(4.8%) other complications. Other
systemic complications as well as neurological complications were not rare.
4)The clinical manifestations of neurological complications were decreased mental
status(drowsy in 57 cases(30.3%), stupor in 63 cases(33.5%), semicoma in 33
cases(17.6%), coma in 13 cases(6.9%), alert in 22 cases(11.7%), focal sign related
to the stroke in 16 cases (7.4%), incontinence in 22 cases(11.7%), seizure in 4
cases(2.4%), psychiatric behavior in 4 cases(2.4%), peripheral neuropathy in 4
cases(2.4%), bracheal plexopathy in 4 cases(2.4%), and torticollis in 1 case(
0.5%). Delayed neurologic sequelae were akinetic mutism in 13 cases(76.5%),
mental deterioration in 6 cases(35.3%), incontinence in 6 cases(35.3%), psychiatric
behavior in 3 cases(17.6%), speech disturbance in 2 cases(11.8%), involuntary
movement in 2 cases(11.8%), and depression in 1 case(5.9%) in order.
5)Cardiovascular complications showed tachycardia in 47 cases(28.3%), ischemic
heart disease in 34 cases(18.6%), right bundle branch block in 6 cases(3.6%), left
axis deviation in 4 cases(2.4%), atrial fibrillation in 3 cases(1.8%), sinus
arrhythmia in 2 cases(1.2%), premature atrial contraction in 1 case(0.6%),
premature ventricular contraction in 1 case(0.6%), primary atrio-ventricular block
in 1 case(0.6%), prolonged QT in 1 case(0.6%). 6)Pulmonary complications were
pneumonia in 23 cases(13.1%), pulmonary edema in 22 cases(12.6%), pneumonia
with pulmonary edema in 3 cases(1.7%), and atelectasis, pulmonary hemorrhage,
empyema, pleurisy in each 1 case(0.6%). 7)Azotemias were 26 cases(14.2%),
clinically confirmed acute renal failures were 4 cases(2%) 8)Rhabdomyolysis was
not rare as 63 cases(33.5%) compared to the previous report. 9)Dermatologic
complications were erythema with bullae in 21 cases(11.9%), erythema without
bullae in 14 cases(7.9%), bullae only in 10 cases(5.6%), laceration in 3
cases(1.65%), and ulceration in 1 case(0.55%). Conclusion ; We must consider
other systemic manifestations as well as neurological symptoms in patients with
CO intoxication since those are not infrequent in Korea. |
|
PDF Links
Full text via DOI
Download Citation
