慢性职业性正己烷中毒患者神经-肌电图表现特征分析  

Analysis on Electroneuromyographic Characteristics of Chronic Occupational N-hexane Poisoning Cases

作　　者：赵乾魁[1,3] 傅绪珍 李思惠 周元陵[1] 周志俊[3] 

机构地区：[1]复旦大学附属金山医院,上海200540 [2]上海市化工职业病防治院,上海200030 [3]复旦大学公共卫生学院,教育部公共卫生安全重点实验室,上海200032

出　　处：《环境与职业医学》2011年第2期68-72,共5页Journal of Environmental and Occupational Medicine

基　　金：国家“十一五”科技支撑计划任务(编号:2006BAI06B01);上海市公共卫生重点学科建设计划(编号08GWZX0303,08GWD20)

摘　　要：[目的]分析职业性正己烷中毒患者神经肌电图表现的特征,明确肌电图表现改变在正己烷中毒诊断中的作用。[方法]对某电子企业2009年9名正己烷中毒患者进行深度调查,收集工人的职业史并对接触毒物进行鉴定,所有患者进行神经专科检查和定期神经肌电图检查,观察中毒患者神经肌电表现的特征。[结果]9例患者都有确切的正己烷接触史,神经电生理检查显示肌肉自发电位增多,收缩时相位异常,神经传导速度下降(P<0.01),远端潜伏期延长(P<0.01),波幅下降(P<0.05)。经营养神经对症处理辅以运动锻炼治疗后9例患者均有好转(P<0.05)。[结论]正己烷慢性中毒患者神经肌电图表现为周围神经受损,运动神经较感觉神经严重,入院治疗后临床症状好转先于神经肌电图改变,在评价恢复程度时应更注重临床表现而不是神经肌电检查。To analyze the characteristics of electroneuromyography（ ENMG ）of chronic occupational n-hexane poisoning cases, and to define the role of ENMG in n-hexane poisoning diagnosis. I Methods I Nine n-hexane poisoning patients admitted into a hospital in April 2009 were investigated thouroughly, all the clinical and occupational history were collected, neurological examination and ENMG were taken periodically, and the exposed toxicant at workplace was identified. [ Results ] The 9 cases were identified as having been exposed to n-hexane and their ENMG showed increased muscle spontaneous potential, abnormal phase emerged in muscle contraction, decreased nerve conduction velocity（ P 〈 0.01 ）, extended distal latency（ P 〈 0.01 ）, and decreased wave amplitude（ P 〈 0.05 ）. After trophie treatment on nerve together with physical exercise, the status of illness was greatly improved. [ Conclusion ] ENMG in chronic occupational n-hexane poisoning cases showed peripheral nerve injury, and the motor nerves were more vulnerable than the sensory nerves. Clinical recovery preceded the improvements of ENMG. It should be more focused on clinical recovery rather than manifestations of ENMG in the evaluation of restoring health.

关 键 词：正己烷 中毒 周围神经损害 神经肌电图 

分 类 号：R135.1[医药卫生—劳动卫生]