二氯乙烷中毒性脑病五例临床及头颅MRI分析  

Clinical and cranial MRI analysis on five cases of toxic encephalopathy induced by dichioroethane

作　　者：杨晓波[1] 胡海涛[2] 张艳[2] 宋水江[2] 

机构地区：[1]复旦大学附属金山医院神经内科,上海200540 [2]浙江大学医学院附属第二医院神经内科

出　　处：《中华劳动卫生职业病杂志》2009年第12期744-746,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨1，2-二氯乙烷（1，2-DCE）中毒性脑病的临床特点、头颅MRI特征及治疗。方法对5例1，2-DEC中毒性脑病患者的临床、头颅MRI及治疗进行观察和分析。结果该组5例患者均为亚急性起病，临床表现无特征性，腰穿检查示脑脊液压力增高。肝肾功能未见异常；头颅MRI示，两侧大脑半球白质、两侧小脑齿状核、两侧苍白球对称受累，T1WI呈略低信号，T2WI呈较明显高信号。经长期、足量使用脱水剂、糖皮质激素治疗，4例患者症状明显好转，1例短期停用，死于突发脑疝。结论1，2-DEC中毒性脑病主要的神经系统表现为颅高压症状；明确的接触史及头颅MRI表现有助于诊断。早期、长程、足量使用糖皮质激素及脱水降颅压治疗，预后良好。Objective To investigate the clinical features, cranial MRI and treatment of toxic encephalopathy induced by 1, 2-dichloroethane（1, 2-DCE）. Methods The clinical, MRI features and treatment of 5 patients with toxic encephalopathy induced by 1,2-DCE were observed and analyzed. Results Five patients all presented with subacute onset with a history of direct exposure to 1,2-DCE. Lumbar cerebrospinal fluid pressures were all increased in 5 patients. All 5 patients had obvious intracranial hypertension. Liver and kidney function had no obvious abnormalities;Cranial MRI showed T1WI low signal and T2WI high signal in bilateral hemispheric white matter, cerebellar dentate nucleus and globus pallidus. After the treatment of dehydrating agent, glucocorticoid and supportive treatment, four patients were clearly improved, and one patient had cerebral hernia formation. Conclusion The main neurological clinical features in patients with 1,2-DEC poisoning is obvious intracranial hypertension. The prognosis is usually good with early and long term use of glucocorticoids and dehydrating agent in poisoning patients.

关 键 词：二氯乙烷类 中毒 磁共振成像 临床方案 

分 类 号：R686[医药卫生—骨科学]