急性1,2-二氯乙烷中毒性脑病病情和预后评估的方法探讨

Study on the methods of severity evaluation and prognosis judgement of acute 1,2-dichloroethane toxic encephalopathy

目的:探讨急性1,2-二氯乙烷(1,2-DCE)中毒性脑病病情评估和预后判断的方法。方法:对12例急性1,2-DCE中毒性脑病病例的临床资料进行回顾分析,分析不同辅助检查对病情评估和预后判断的价值。结果:本组轻度1,2-DCE中毒性脑病2例,中度3例,重度7例;重度病例中死亡4例,治疗无效1例。重度病例的血液学检查可出现更多的异常项目;脑电图检查因病情不同呈现轻重不等的异常结果,是本病脑功能和预后评估的一个敏感方法;脑脊液检查压力增高和头颅CT早期出现弥漫性脑组织肿胀是病情危重、预后不良的表现;头颅MR对本病脑损伤的早期诊断具有更大价值,并可以区分不同类型的脑水肿。结论:不同的辅助检查方法对急性1,2-DCE中毒性脑病的病情评估和预后判断具有不同的价值,综合分析各项辅助检查结果可以更有效地指导本病的临床救治。

Objective：To investigate the methods of severity evaluation and prognosis judgement of acute 1,2- dichloroethane （1,2-DCE） toxic encepbalopathy. Method： The medical records of 12 patients with acute 1,2-DCE toxic encephalopathy were studied retrospectively. The value of different auxiliary examination was analyzed. Re- suit： In this study group there were 2 mild 1,2-DCE toxic encephalopathy cases,3 moderate and 7 severe cases. Of the severe cases, 4 cases were died, 1 case was ineffective treatment. More abnormal items appeared in blood exami- nation of the severe cases. Presenting different degree of abnormal results for the different state of illness,EEG ex- amination was a sensitive method of brain function and prognosis evaluation of the disease. The rise Of cerebrospi- nal ）[luid pressure and the diffuse cerebral edema appearing in early cranial＇CT were the representation of critical condition and adverse prognosis. Cranial MR in early diagnosis of brain injury is of greater value for the disease, and can distinguish between different types of cerebral edema. Conclusion：Different auxiliary examination provides different value for severity evaluation and prognosis judgement of acute 1,2-DCE toxic encephalopathy. Compre-hensive analysis of various auxiliary examination results can effectively guide the clinical treatment.