目的:分析1例"中枢一外周一中枢"康复模式治疗一氧化碳中毒迟发性脑病患者认知障碍的病例,为临床认知障碍康复提供思路。

方法:报道1例成年一氧化碳中毒迟发性脑病患者的临床资料、康复诊疗过程,以及认知功能、语言功能和日常生活能力变化情况,并结合相关文献进行疗效分析。

结果:男性患者,42岁,因“一氧化碳中毒后认知障碍 55 d"入院,表现为言语不能、反应迟钝部分查体不配合。头部MRI显示双侧基底节区、放射冠区等见对称性分布的斑片状异常信号。临床诊断为一氧化碳中毒迟发性脑病。给予患者“高压氧治疗+经颅磁刺激+经颅直流电刺激+Schuell 语言训练+认知训练"进行中枢干预,“励-协夫曼言语治疗训练+日常生活能力训练”进行外周干预后,患者认知功能明显提高。患者入院时改良 Barthel指数为 15 分,出院时为 60 分，日常生活基本自理。

结论:一氧化碳中毒迟发性脑病常导致严重的认知障碍,预后较差,致残率高。采用“中枢一外周一中枢"康复模式应用于一氧化碳中毒迟发性脑病的认知障碍,能有效促进患者的认知功能恢复。

Objective: To analyse a case report of "central- peripheral- central" rehabilitation modefor cognitive impairment in a patient with delayed encephalopathy after carbon monoxide poisoning (DEACMP), and to provide ideas for clinical cognitive impairment rehabilitation.

Methods:The clinical data, rehabilitation diagnosis, treatment process, and the changes ofcognitive function, language function and daily living ability of an adult patient withDEACMP were reported, and the efficacy was analyzed in conjunction with the relevantliterature.

Results: A 42 -year -old male patient was admitted to the hospital with“55 days ofcognitive impairment after carbon monoxide poisoning", and physical examinationrevealed that he was unable to speak, unresponsive, and uncooperative. MRl of the headshowed symmetrical patchy abnormal signals in the basal ganglia area and radiativecrown area, which was clinically diagnosed as DEACMP. The patient was given "hyperbaricoxygen therapy+transcranial magnetic stimulation+transcranial direct current+Schuelllanguage training+ognitive training"for central regulation, and "Lee Silverman VoiceTreatment (LSVT) training+daily living ability training" for peripheral intervention, withhis cognitive function had significantly improved. The score of modified Barthel index was15 points at admission and 60 points at discharge. The result showed that the patientcould achieve basic self- care in daily living.

Conclusion: DEACMP often leads to severe cognitive impairment, poor prognosis and highdisability rate. The application of"central-peripheral-central"rehabilitation mode tocognitive impairment of DEACMP can effectively promote the recovery of cognitivefunction in patients.