吸食笑气致脊髓亚急性联合变性一例  

A case of subacute combined degeneration of spinal cord caused by inhaling laughing gas

作　　者：刘杨 王志晔 张作念 倪梦园 陆兆敏 潘锡近[2] Liu Yang;Wang Zhiye;Zhang Zuonlan;Ni Mengyuan;Lu Zhaomin;Pan Xijin(Department of Neurology,Nanjing Meishan Hospital,Nanjing 210039,China;Department of Neurology,Drum Tower Hospital,Nanjing University,Nanjing 210000,China)

机构地区：[1]南京梅山医院神经科,210039 [2]南京大学附属鼓楼医院神经科,210000

出　　处：《中华劳动卫生职业病杂志》2021年第11期868-870,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：笑气(一氧化二氮)因价格低廉、容易获得,目前存在滥用情况。本文探讨1例吸食笑气致脊髓亚急性联合变性患者的临床表现,患者出现四肢麻木、步态不稳,血清维生素B_(12)水平降低,颈椎MRI提示颈髓(C2-6)侧索及后索内节段性异常信号;神经电生理检查示四肢周围神经损害。经补充维生素B_(12)治疗,患者病情逐渐好转。临床医生诊断脊髓亚急性联合变性,尤其患者无消化道疾病、节食、营养不良等情况时,需仔细询问有无吸食笑气史,避免漏诊。Laughing gas(Nitrogen monoxide)is currently abused due to its low price and easy availability.This article discussed the clinical manifestations of a patient with subacute combined degeneration of the spinal cord caused by inhalation of laughing gas.The patient developed numbness of extremities,unstable walking,and decreased serum vitamin B_(12) level.MRI of the cervical spine showed abnormal signals in the lateral and posterior cords of the cervical spinal cord(C2-6),neuroelectrophysiological examination showed peripheral nerve damage in the extremities.After treatment with vitamin B_(12) supplementation,the patient's condition gradually improved.Clinicians diagnose subacute combined degeneration of the spinal cord,especially when the patient has no gastrointestinal disease,diet,malnutrition,etc.,they need to carefully inquire about the history of nitrous oxide inhalation to avoid missed diagnosis.

关 键 词：吸入剂滥用 中毒 笑气 一氧化二氮 脊髓亚急性联合变性 

分 类 号：R744.6[医药卫生—神经病学与精神病学]