关键词: 一氧化碳中毒, 迟发性脑病, 癫痫, 预后

Abstract: Background　Previous studies of patients with delayed encephalopathy after acute carbon monoxide poisoning （DEACMP） mainly focused on the symptoms，such as mental retardation，extrapyramidal dysfunction，rather than secondary epilepsy.The investigation of the incidence and clinical features of secondary epilepsy after DEACMP would be beneficial to the aforesaid issues.Objective　To analyze the clinical features of DEACMP patients with secondary epilepsy.To compare the clinical manifestations，the therapeutic effects and prognosis between DEACMP patients with and without secondary epilepsy,in order to provide a basis for predicting the prognosis of DEACMP patients with secondary epilepsy.Methods　450 DEACMP patients admitted to eight hospitals of the Second Affiliated Hospital of Xinxiang Medical University，the First Affiliated Hospital of Xinxiang Medical University，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang Center Hospital，the First People’s Hospital of Xinxiang，the Second People’s Hospital of Xinxiang，the 371st Center Hospital of PLA and Henan Honliv Hospital from January 2001 to January 2014 were recruited，and 272 of these patients were eligible for inclusion and exclusion criteria and included in our study.The patients’ clinical condition changes，treatment effect and prognosis were recorded through outpatient follow-up and telephone follow-up.Results　In the 272 patients,20 cases（7.4%） got secondary epilepsy，and 17（85.0%） of them epileptic seizures occurred within 6 months after DEACMP.There were no statistically significant differences in gender，age，coma duration，latent phase between DEACMP patients with and without secondary epilepsy （P>0.05），but there was statistically significant difference in severity of illness（P<0.05）. There was statistically significant difference in treatment effect（Z=5.098，P<0.01）.12 cases of DEACMP patients with secondary epilepsy died during the follow up and the mortality was 60.0%,while 52 cases of DEACMP patients without secondary epilepsy died and the mortality was 20.6%.There was statistically significant difference in mortality between the two groups（χ2=15.95，P<0.01）.Conclusion　The DEACMP patients with secondary epilepsy are characteristic of severe condition，poor treatment effect and high mortality.It is important for improving the treatment effect and prognosis of DEACMP patients to prevent the secondary epilepsy，especially epileptic seizure duration.

Key words: Carbon monoxide poisoning, Delayed encephalopathy, Epilepsy, Prognosis