误诊为格林-巴利综合征的铊中毒二例临床探析  

Analysis of Thallium Poisoning Misdiagnosed as Guillain-Barre Syndrome in Two Patients

作　　者：谢平辉 卢伟[1] 雷强[1] 张金囡[1] 游红[1] 

机构地区：[1]中南大学湘雅二医院神经内科,长沙410011

出　　处：《临床误诊误治》2014年第5期42-45,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨铊中毒的临床特点及诊治措施,提高其诊治水平。方法对我科近期收治的误诊为格林-巴利综合征的铊中毒2例的临床资料进行回顾分析,并复习相关文献。结果 2例均因四肢麻木、疼痛及乏力等就诊,皆误诊为格林-巴利综合征,予相应治疗无效。1例死亡后经尸检证实铊中毒;1例因脱发高度怀疑铊中毒,经尿检证实铊中毒,经积极治疗后恢复较好。结论以四肢麻木、疼痛及乏力为首发症状的铊中毒易误诊为格林-巴利综合征。加强对其认识,详细病史询问及认真病情分析可避免或减少铊中毒误诊。Objective To explore clinical characteristics and diagnosis and treatment measures of thallium poisoning in order to improve the diagnosis and treatment efficiency. Methods Clinical data of 2 patients with thallium poisoning misdi-agnosed as having Guillain-Barre syndrome was retrospectively analyzed,and related literature was also reviewed. Results The two patients visited doctors for limbs anesthesia,pain and acratia,and were all misdiagnosed as having Guillain-Barre syndrome,but patients′conditions did not improve after corresponding treatment. One patient died,and thallium poisoning was confirmed by autopsy;another one was highly suspected of thallium poisoning because of baldness,and was confirmed by uri-nalysis,and recovered after active treatment. Conclusion Thallium poisoning patients with the initial symptoms of limbs an-esthesia,pain and acratia may be easily misdiagnosed as having Guillain-Barre syndrome,and the misdiagnosis rate can be re-duced by enhancing the understanding of thallium poisoning,a detailed history enquiry and analyzing the patients′conditions.

关 键 词：铊中毒 误诊 格林 -巴利综合征 

分 类 号：R595.2[医药卫生—内科学]