1,2-二氯乙烷中毒性脑病6例临床分析

6 case analysis of toxic encephalopathy induced by 1,2-dichloroethane

目的探讨1,2二氯乙烷中毒性脑病的临床表现及影像学分析。方法对6例1,2二氯乙烷中毒性脑病患者的临床、头部MRI、治疗预后进行观察分析。结果该组6例为亚急性或迟发性起病,病情进行性加重,均有明确的1,2二氯乙烷接触史。亚急性起病以颅高压及全脑症状为主,迟发性以精神状态改变及锥体外系症状为主。头部MRI表现为对称、弥漫、累及灰白质的病变,主要累及大脑半球、小脑齿状核、基底节、丘脑等。经治疗后,6例中2例因脑疝死亡,3例临床症状改善不明显,1例临床治愈。结论认识1,2二氯乙烷中毒性脑病各阶段的临床表现及影像学特点,使本病患者得到及时有效诊治。有1,2二氯乙烷接触史患者需定期复查MRI,尽早发现病变,降低遗留神经系统损害的几率及程度。

Objective To study the clinical manifestations and imaging features of toxic encephalopathy induced by1,2-dichloroethane. Methods Six patients with toxic encephalopathy induced by 1,2-dichloroethane were observed and analyzed with clinical manifestation 、MRI imaging 、treatment and prognosis. Results All patients presented with subacute or late delayed onset and with a history of direct exposure to 1,2-dichloroethane. Patients with subacute onset mainly represented for cranial pressure and whole brain injury symptomns and late delayed onset mainly manifestedfor mental state changes and extropyramidal symptoms. MRI examination showed long T1 and long T2 relaxation times in the white matter、gray matters and deep nucleus. After the treatment,two of them died because of cerebral hernmia,the status of three patients were improved unconspicuous,1 patients was cured. Conclusion To understand the stages of clinical manifestation and imagine features on toxic encephalopathy induced by 1,2-dichloroethane,making these patients get emergency treatment. It is a good methodnecessary that MRI was examined regularly in order to discover early toxic encephalopathy.