硫酸二甲酯急性中毒在鼻咽喉的表现与转归观察  

Clinical observation on the manifestations in nose pharynx and throat and on their prognosis of acute DMS poisoning

作　　者：吴健[1] 陈著声[1] 康宗辉[1] 叶莲妹[1] 杨磊[1] 

机构地区：[1]福建医科大学南平市第一医院教学医院耳鼻咽喉-头颈外科,南平市耳鼻咽喉研究所353000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2006年第6期363-366,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的观察硫酸二甲酯急性中毒在鼻、咽、喉部的表现与转归。方法22例硫酸二甲酯急性中毒患者,根据其与毒物的接触情况分为直接接触组、消防员1组、消防员2组和医护组,均由专人全程检查、治疗,仔细观察患者临床经过,重点分析其鼻咽喉部的病理表现与转归。结果鼻塞、频繁喷嚏是鼻部主要症状,均有与中毒程度相平行的鼻腔伪膜形成;咽部表现主要有悬雍垂和软腭充血水肿,病情与中毒程度呈正比;中度以上中毒者均可出现喉梗阻;重度中毒者可出现声带坏死、固定。结论硫酸二甲酯急性中毒时可以伴有明显的鼻咽喉病变,及时处理有利于缩短病程,促进恢复。Objective To investigate the clinical features of acute dimethyl sulfate （DMS） poisoning manifested in nose, pharynx and throat and the prognosis of these lesions. Methods Twentytwo cases with acute DMS poisoning were included in this study and they were divided into 4 groups according to the close degree of cases contacting the toxic material, i.e. group 1 being the cases conmeting DMS directly, group 2 being the firemen without mask worn when contacting the toxic material, group 3 being the firemen with mask worn when contacting the toxic material, and group 4 being the medical workers in the accident field. They were all treated and observed on by special persons throughout the whole therapeutic process. Then, focused attention was put on their clinical manifestations in nose, pharynx and throat and the conversion of them. Results Nasal blockage and frequently sneezing were the main symptoms in nose, with bogus membrane formation in nasal cavity in a parallel tendency with the toxic degree. The pathological changes in the pharynx were mainly congestion and edema of uvula and soft palate, showing a positive correlation of the lesion with the degree of intoxication. All the cases with the degree of intoxication at or above medium might undergo the process of laryngeal obstruction, and those suffering a degree of seriously intoxicated should develop to such lesions as vocal cord necrosis or immobilization. Conclusions Significant pathological changes may be companied with acute DMS poisoning in nose, pharynx and throat, and timely treatment can promote the process of lesion recovery largely.

关 键 词：硫酸二甲酯 急性中毒 鼻咽喉表现 转归 

分 类 号：R766.5[医药卫生—耳鼻咽喉科] R595[医药卫生—临床医学]