Pulmonary encephalopathy
Introduction
Introduction to pulmonary encephalopathy Pulmonary encephalopathy, also known as pulmonary heart and brain syndrome, is a brain tissue damage and cerebral circulation disorder caused by chronic bronchitis complicated with emphysema, pulmonary heart disease and pulmonary failure. Mainly based on chronic lung disease with pulmonary failure; clinical manifestations of conscious disturbances, neurological, psychiatric symptoms and localized neurological signs; blood gas analysis has pulmonary dysfunction and hypercapnia; exclude other causes of neurological and mental disorders And diagnose. basic knowledge The proportion of illness: 0.012% Susceptible people: no special people Mode of infection: non-infectious Complications: upper gastrointestinal bleeding, diarrhea
Cause
Cause of pulmonary encephalopathy
Lung lesions (70%)
Due to chronic emphysema, chronic bronchitis, tuberculosis and other scoliosis, back bend, amyotrophic lateral sclerosis, myasthenia gravis. Mainly due to lung damage caused by carbon dioxide retention and hypoxia, causing hypercapnia and hypoxemia.
Pulmonary circulatory disorder and pulmonary hypertension (10%)
Pulmonary or systemic diseases leading to pulmonary circulatory disorders and pulmonary hypertension, leading to CO2 poisoning, or CO2 anesthesia, respiratory acidosis and hypoxia, induce or aggravate brain tissue damage, and cause pulmonary encephalopathy.
Prevention
Pulmonary encephalopathy prevention
1. Strengthen safety protection, transfer patients to safe rooms, avoid windows, to avoid accidents, remove unnecessary equipment and dangerous items such as hot water bottles, knives, scissors, and ropes to avoid injury and self-injury.
2. For patients with symptoms of early pulmonary encephalopathy, in addition to the necessary monitoring, it is necessary to get in touch with the patient's family in time to explain the condition, let the family cooperate with the treatment, and ask the family to accompany them, and at the same time send a full-time nursing staff to guard.
Complication
Pulmonary encephalopathy complications Complications upper gastrointestinal bleeding diarrhea
Complications include shock, hypotonicemia, renal failure, liver failure, electrolyte imbalance, gastrointestinal symptoms such as vomiting, diarrhea, and upper gastrointestinal bleeding.
Symptom
Pulmonary encephalopathy symptoms common symptoms coma memory disorder head slumbering mental disorder
(1) Mental disorders: early symptoms can be manifested as headache, dizziness, memory loss, lack of energy, and reduced work ability. Followed by different levels of disturbance of consciousness, the light is drowsiness, lethargic, and then coma. Mainly caused by carbon dioxide anesthesia caused by hypoxia and hypercapnia. In addition, there may be various dyskinesias such as increased intracranial pressure, optic nerve head edema and stun tremor, myoclonus, generalized tonic-clonic seizures. Psychiatric symptoms can be expressed as excitement, restlessness, increased speech, hallucinations, delusions, and so on.
(2) Neurological symptoms: Park Wing-like tremor or seizures, myoclonus, papilledema, retinal hemorrhage, diplopia, etc.
Examine
Examination of pulmonary encephalopathy
1. Blood gas analysis showed that PaCO2 increased, carbon dioxide binding increased, standard bicarbonate (SB) and residual alkali (BE) increased and blood pH decreased.
2, cerebrospinal fluid pressure increased, red blood cells increased.
3, EEG showed diffuse chronic wave abnormalities of varying degrees, and may have paroxysmal changes.
Diagnosis
Diagnosis and diagnosis of pulmonary encephalopathy
diagnosis
Mainly based on chronic lung disease with pulmonary failure; clinical manifestations of conscious disturbances, neurological, psychiatric symptoms and localized neurological signs; blood gas analysis has pulmonary dysfunction and hypercapnia; exclude other causes of neurological and mental disorders And diagnose.
Differential diagnosis
1. Hepatic encephalopathy see pulmonary encephalopathy.
2. Renal encephalopathy see renal encephalopathy.
3. Diabetic coma patients, patients with a history of diabetes, before the onset of various causes of disturbance of consciousness, blood sugar is significantly increased, ketoacidosis has a special rotten apple flavor.
