金属汞中毒患者临床特点及治疗转归分析  

Clinical characteristics and treatment outcomes of patients with metallic mercury poisoning

作　　者：胡丹凤 刘胜萍[1] 李艳[1] Hu Danfeng;Liu Shengping;Li Yan(Department of Occupational Disease,the Third People's Hospital of Hefei,Hefei 230000,China)

机构地区：[1]合肥市第三人民医院职业病科,230000

出　　处：《中华保健医学杂志》2025年第1期123-125,共3页Chinese Journal of Health Care and Medicine

基　　金：安徽省卫生健康科研项目(AHWJ2022b104)。

摘　　要：目的分析金属汞中毒患者临床特点及治疗转归情况,以提高临床诊治水平。方法回顾性选取2020年1月~2024年1月期间合肥市第三人民医院收治的190例金属汞中毒患者,分析其临床资料。其中选取80例慢性金属汞中毒患者,并按照随机数表法分为对照组及观察组,每组均为40例,对照组给予青霉胺驱汞治疗,观察组给予二巯基丙磺钠驱汞治疗,分析治疗效果及转归情况。结果190例金属汞中毒患者中,以女性患者居多(90.00%),平均年龄(45.54±8.09)岁;其中180例为职业接触中毒,包括温度计生产厂170例、金属鎏金10例;10例为非职业性中毒,包括使用化妆品经皮肤吸入者8例、使用含汞偏方经皮肤吸入者2例。15例急性中毒,主要表现为呼吸系统症状,神经-精神障碍。175例为慢性金属汞中毒,主要表现为神经-精神障碍,口腔-牙龈炎,震颤等,实验室检查主要表现为血肌酐下降,血脂升高等,并发症主要为肾病综合征。80例慢性汞中毒患者经治疗后,尿汞水平均下降,且观察组低于对照组,差异有统计学意义(t=28.284,P<0.001)。经治疗后所有患者临床症状得到明显好转。结论对于金属汞中毒患者,应详细询问临床表现及接触途径,减少误诊及漏诊的发生,并在明确诊断后积极进行病情评估及驱汞治疗,首选二巯丙磺钠,以改善临床症状,减少靶器官损害。Objective To analyze the clinical characteristics and treatment outcomes of patients with metallic mercury poisoning,so as to improve the level of clinical diagnosis and treatment.Methods A retrospective study was conducted.A total of 190 patients with metallic mercury poisoning admitted to the Third People's Hospital of Hefei from January 2020 to January 2024 were selected.Their clinical data were analyzed.Eighty patients with chronic metallic mercury poisoning were selected and divided into a control group and an observation group,with 40 cases in each group.The control group underwent mercury displacement treatment with penicillamine while the observation group underwent mercury displacement treatment with sodium dimercaptopropane sulfonate.Therapeutic effects and outcomes were analyzed.Results The majority of the 190 patients were female,with an average age of(45.54±8.09)years.There were 180 cases of occupational exposure poisoning,including 170 cases from thermometer manufacturers and 10 cases from gilding industry.There were 10 cases of non-occupational poisoning,including 8 cases poisoned by inhalation through the skin after using cosmetics and 2 cases poisoned by inhalation through the skin after using mercury-containing folk prescriptions.15 patients had acute poisoning.175 patients had chronic poisoning.After treatment,urine mercury levels in both groups were reduced,and urine mercury level in the observation group was lower than that in the control group(t=28.284,P<0.001).Clinical symptoms of all patients were significantly improved after treatment.Conclusion For patients with metallic mercury poisoning,detailed clinical manifestations and contact routes should be inquired about to reduce the occurrence of misdiagnosis and missed diagnosis.Besides,condition evaluation and mercury displacement treatment(dimercaptopropane sulfonate as the first choice)should be carried out actively after confirmed diagnosis to improve clinical symptoms and reduce target-organ damage.

关 键 词：金属汞中毒 临床特点 治疗 转归 

分 类 号：R595.2[医药卫生—内科学]