慢性正己烷中毒临床特征及治疗要点(33例临床分析)

Study on clinical features and treatment highlights of chronic n-hexane poisoning

目的探讨职业性慢性正己烷中毒的临床特征及治疗要点。方法对本院慢性正己烷中毒33例住院病例资料进行回顾性分析,总结职业性正己烷中毒的临床特征和治疗要点。有9例在采用鼠源性神经生长因子(mNGF)治疗后1个月、6个月及12个月,3次检测血清内源性NGF水平,并与正常人群对照比较。结果 (1)职业性慢性正己烷中毒以周围神经系统损害为主;(2)神经-肌电图检测在轻、中、重度中毒中均显示神经原性损害(100%),肌电图恢复先于神经传导速度恢复;(3)血清NGF水平检测3次结果均为阴性;(4)9例患者经1年mNGF治疗,有效率100%,其中临床治愈率77.78%,基本治愈率22.22%。结论职业性慢性正己烷中毒的临床特征以周围神经系统损害表现为主,神经-肌电图检查是慢性正己烷中毒主要监测指标。mNGF治疗职业性正己烷中毒性周围神经病的疗效肯定、安全,是治疗慢性正己烷中毒的理想药物。

Objective To study the clinical features and treatment points of chronic n-hexane poisoning.Methods（1）collecting 33 medical records of chronic n-hexane poisoning in our hospital,summarizing and analyzing their main clinical manifestations and treatment points by retrospective study of 33 cases;（2）9 patients were treated with mouse nerve growth factor（mNGF）and detected serum endogenous NGF one month,6 months and one year after injection of mNGF respectively,compared these results with general people carefully.Results The results showed that：（1）the main manifestation of occupational chronic n-hexane poisoning is peripheral nerve damage;（2）neurogenic lesion may be found in all the mild,moderate and severe poisoning cases by electroneuromyography（100%）,the improvement of electromyogram was faster than that of nerve conduction velocity;（3）detections of serum endogenous NGF were negative after injection of mNGF;（4）nine patients all improved after one year treatment with mNGF,the clinical recovery rate is 77.78% and the basic recovery rate is 22.22%.Conclusion（1）The major clinical feature of occupational chronic n-hexane poisoning is peripheral nerve system,electroneuromyography is an important monitoring measure for chronic n-hexane poisoning;（2）mNGF is a reliable therapeutic drug,effective and safe.