职业性急性1,2-二氯乙烷中毒致中毒性脑病18例分析  

Analysis of 18 cases of toxic encephalopathy caused by occupational acute 1,2-dichloroethane poisoning

作　　者：陈育全[1,2] 林毓嫱[1,2] 张伊莉 蒋文中[1] 杨志前 刘移民[1,2] Chen Yuquan;Lin Yuqiang;Zhang Yili;Jiang Wenzhong;Yang Zhiqian;Liu Yimin(Guangzhou Prevention and Treatment Hospital of Occupational Diseases,Guangzhou 510620,China;School of Public Health,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]广州市职业病防治院,510620 [2]中山大学公共卫生学院,广州510080

出　　处：《中华劳动卫生职业病杂志》2019年第10期778-780,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：广州市"121人才梯队工程"后备人才项目。

摘　　要：分析广州市职业病防治院收治的职业性急性1,2-二氯乙烷(1,2-DCE)中毒致中毒性脑病患者18例。以头晕、头痛、反应迟钝等神经系统损害症状为主要表现,头颅CT均表现为不同程度的弥漫性脑白质病变。头颅MRI表现为两侧大脑半球白质广泛受累,受累白质区域为T1WI低信号,T2WI高信号,T2-Flair高信号改变;腰椎穿刺检查脑脊液压力(262.5±48.39)mm H2O,经治疗脑脊液压力恢复平均时间(161.56±75.27)d。职业性急性1,2-DCE中毒所致中毒性脑病可表现为脑脊液压力持续异常,治疗中脑脊液压力下降缓慢;及早行头颅影像学和腰椎穿刺检查,有利于早期发现颅内压情况;脑脊液压力动态监测可对急性1,2-DCE中毒在长时间、多种类脱水剂治疗上提供指导。Retrospective analysis of 18 cases of occupational acute 1,2-dichloroethane(1,2-DCE)poisoning.The results showed that all patients have the main manifestations such as dizziness,headache,unresponsiveness and other symptoms of nervous system damage;Brain CT showed varying degrees of diffuse white matter lesions.Brain MRI showed extensive involvement of white matter in both cerebral hemispheres.Affected white matter area presented low intensity on T1WI,hyperintensity on T2WI and T2-Flair;Lumbar puncture examination of cerebrospinal fluid(CSF)pressure(262.5±48.39)mm H2O;After treatment,the required time for CSF pressure to restore was(161.56±75.27)days(50-280)days.Summary,Occupational acute 1,2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure,and the CSF pressure drops slowly during treatment;Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1,2-DCE poisoning.Dynamic monitoring of CSF provides guidance for acute 1,2-DCE poisoning with a long time of treatment and various types of dehydrating agents.

关 键 词：职业病 二氯乙烷类 中毒 

分 类 号：R74[医药卫生—神经病学与精神病学]