急性有机锡中毒性脑病38例的临床表现及血钾分析

Analysis on clinical manifestations and serum potassium in 38 cases of encephalopathy after acute organotin poisoning

目的分析38例急性有机锡中毒性脑病的临床表现及血钾变化,以便更好地进行诊断和诊疗工作。方法采用回顾性方法对38例急性有机锡中毒性脑病患者的临床表现及血钾变化情况,进行总结,分析临床特点,比较治疗前后血钾变化及低血钾程度与中毒轻重的关系。结果 38例急性有机锡中毒性脑病患者临床表现中腱反射减弱者、头晕头痛者及睡眠障碍者较常见,分别占92.11%、89.47%及71.45%;治疗前38例患者血钾平均(2.87±0.41)mmol/L,治疗10 d后血钾水平明显升高,平均(3.92±0.63)mmol/L,差异有统计学意义(t=8.61,P<0.01)。且低血钾程度与中毒轻重呈正相关(r=0.026,P<0.05)。结论急性有机锡中毒性脑病患者临床常有腱反射减弱、头晕头痛及睡眠障碍等表现,血钾水平可作为病情判断及治疗评价的指标。

[ Objective] To analyze the clinical manifestations and serum potassium change of 38 cases of encephalopathy after acute organotin poisoning, improve the diagnosis and treatment. [ Methods ] The clinical manifestations and serum potassium change of 38 cases of encephalopathy after acute organotin poisoning were summarized by retrospective method, to analyze the clinical manifesta- tions, compare the serum potassium level between before and after treatment, and explore the relationship between hypopotassemia degree and poisoning severity. [ Results ] The main clinical manifestations of 38 cases of encephalopathy after acute organotin poison- ing included tendon hyporeflexia, dizziness and headache, and dyssomnia, which accounted for 92.11%, 89.47% and 71.45% respectively. The average level of serum potassium before treatment was （2.87 ±0. 41 ） mmol/L, while that after 10 days of treat- ment was （ 3.92 ±0. 63 ） mmol/L, and the difference was significant （ t = 8.61, P 〈 0. 01 ）. The was a positive correlation between hypopotassemia degree and poisoning severity （ r = 0. 026, P 〈 0. 05 ）. [ Conclusion ] The patients with encephalopathy after acute organotin poisoning have the clinical manifestations of tendon hyporeilexia, dizziness and headache, and dyssomnia. The level of serum potassium can be used as the index of diagnosis and treatment evaluation.