亚急性1,2-二氯乙烷中毒患者临床过程的动态观察  

Dynamic observation of clinical course in patients with subacute 1, 2-dichloroethane poisoning

作　　者：刘薇薇[1] 陈育全[1] 潘静[2] 杨志前[1] 刘移民[3] 

机构地区：[1]广州市第十二人民医院职业病科,510620 [2]广州市第十二人民医院职护理部,510620 [3]广州市第十二人民医院科技委员会,510620

出　　处：《中华劳动卫生职业病杂志》2015年第3期190-193,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的 动态观察亚急性1,2-二氯乙烷中毒的临床特征与规律,为诊断、治疗和预后提供依据.方法 回顾性分析51例亚急性1,2-二氯乙烷中毒病例,按临床表现分为颅压高为主A组25例,肢体震颤为主B组18例,精神行为异常为主C组8例,观察临床主要症状体征、头颅CT异常及脑脊液压力指标,比较各组发病、恶化、好转和基本恢复持续的时间及全程的时间.结果 51例患者只有头颅CT变化显示恶化时间与症状体征恶化时间的差异有统计学意义（t=2.555,P＜0.05）.3组间症状体征、头颅CT持续时间比较,C组病情发生恶化最快,与A组和B组比较,差异均有统计学意义（P＜0.01）,B组症状体征好转、基本恢复和全病程持续时间最长[（50.50±27.69）d、（92.39±55.05）d、（150.22±77.47）d],与A组和C组比较,差异均有统计学意义（P＜0.05）,但B组头颅CT恢复最快[（46.50±23.30）d]、全病程持续时间最短[（99.61 ±46.69）d],与A组[分别为（84.08±48.06）d、（145.08±58.99）d]比较,差异均有统计学意义（P＜0.05）.A组头颅CT、脑脊液压力好转时间及全病程持续时间比症状体征持续时间长,差异均有统计学意义（P＜0.01）.B组以肢体震颤的症状体征恶化时间比头颅CT异常变化时间来得早,差异有统计学意义（P＜0.05）,而恢复时间和整个病程持续时间均较头颅CT恢复所需要的时间长;C组精神异常症状体征恶化表现较头颅CT异常变化出现的时间早,差异有统计学意义（P＜0.01或P＜0.05）.结论 亚急性1,2.二氯乙烷中毒的临床特征为中枢神经系统损害表现,病程不同阶段、病变累及的部位和程度不同时其临床症状体征各异,即使脱离接触后仍继续恶化,病情迁延,病情重和复杂多变.Objective To observe the clinical characteristics and regular patterns of subacute 1,2-dichloroethane poisoning patients for providing evidences to it＇s diagnosis、treatment and prognosis.Methods 51 cases of subacute 1,2-dichloroethane poisoning analyzed.They were divided into 3 groups according to their main clinical manifestation：group A mainly with intracranial hypertension （n=25）,group B with limbs tremor （n =18）,group C with mental and behavior disorder （n =8）.All cases＇ clinical symptoms、cranial computer tomography、cerebrospinal pressure （Group A）were observed,the durations of the onset、deterioration、improvement、recovery and whole course of the disease were compared between groups and in each group.Results In all of 51 cases,only the differences between the deterioration duration of cranial CT and symptom was significantly （t=2.555,P〈0.05）,which indicate the deterioration of symptom was earlier than radiological change.The symptom deterioration of group C was the fastest than group A and group B （P〈0.00）.As to the change of symptom duration,group B＇s improvement 、recovery and whole course was the longest comparing with group A and group C （P〈0.05）.As to the change of cranial CT duration,group B＇s recovery duration was the shortest and group A＇s recovery duration was the longest （P〈0.01）;group B＇s whole course was also the shortest and group A＇s whole course was the longest （P〈0.05）.The clinical course of symptoms、cranial computer tomography、cerebrospinal pressure（Group A） was compared in each group,in group A,the duration of improvement and whole course of the cranial CT and cerebrospinal pressure change was longer than that of the symptom change （P〈0.01）,this indicated that group A has longer asymptomatic intracranial hypertension and their cranial radiography recover slowly.In group B,their symptoms （3.94±4.31 days） deteriorated is earlier than cranial CT changes （P〈0.05）,the recovery （92.39±55.04 days�

关 键 词：1 2-二氯乙烷 中毒 神经行为学表现 体层摄影术 

分 类 号：R135.1[医药卫生—劳动卫生]