摘要
目的分析职业性急性1,2-二氯乙烷中毒(1,2-DCE)死亡病例的临床特点及其救治。方法回顾性分析3例职业性急性1,2-DCE中毒死亡病例的临床资料。结果 3例病例均为中年女性,均有明确的职业性1,2-DCE接触史,从发病到死亡分别为48、25、32d。2例为散发发病。临床上主要表现为中毒性脑病。首发症状1例为头晕、眼花,2例为头痛。死亡前,3例病例脑水肿持续时间长,且容易反复和加重;2例合并肺部感染、消化道出血及肾功能异常等。3例病例均诊断为职业性急性重度1,2-DCE中毒。1例死于脑疝,2例死于多器官功能衰竭。结论职业性急性1,2-DCE中毒脑水肿、颅压高持续时间长,病情可突然恶化;应密切观察神经系统症状体征,早期发现脑水肿,及时处理,防治反复;特别要警惕脑疝和多器官功能衰竭发生。
Objective To analyze the clinical characteristics and treatment of death cases from occupational acute1,2-dichloroethane( 1,2-DCE) poisoning. Methods The clinical data of 3 death cases of occupational acute 1,2-DCE poisoning were retrospectively analyzed. Results All the 3 cases were middle-aged women with a clear history of occupational exposure to 1,2-DCE. The duration from onset to death of these cases was 48,25 and 32 days. Two cases were sporadic. Clinically,it was characterized by toxic encephalopathy. The first symptom was dizziness in 1 case and headache in 2 cases. Patients had a long duration of cerebral edema which was prone to recurrence and aggravation before death. Two cases omplicated by pulmonary infection,gastrointestinal hemorrhage and renal dysfunction. All the 3 cases were diagnosed as severe occupational acute 1,2-DCE poisoning. One died of cerebral hernia and two died of multiple organ failure. Conclusion Occupational acute 1,2-DCE poisoning intoxication with brain edema and long duration of high cranial pressure can lead to sudden deterioration of the disease. The symptoms and signs of the nervous system should be closely observed. Cerebral edema should be detected early with treated timely to prevent disease relapse. Special attention should be paid to the occurrence of cerebral palsy and multiple organ failure.
作者
夏丽华
黄家文
邓小峰
李斌
曾子芳
XIA Lihua;HUANG Jiawen;DENG Xiaofeng;LI Bin;ZENG Zifang(Guangdong Province Hospital for Occupational Disease Prevention and Treatmen;Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment,Guangzhou,Guangdong 510300,China)
出处
《中国职业医学》
CAS
北大核心
2018年第5期601-605,共5页
China Occupational Medicine
基金
国家科技支撑计划项目(2014BAI12B01)
国家临床重点专科建设项目(2011-09)
国家自然科学基金(81872601
81202245)
广东省医学科学技术研究基金(A2018152)
广东省职业病防治重点实验室(2017B030314152)
关键词
急性中毒
1
2-二氯乙烷
脑水肿
脑疝
死亡
Acute poisoning
1,2-Dichloroethane
Brain edema
Cerebral hernia
Death