一氧化二氮暴露对神经系统的影响进展

Progress in the effects of nitrous oxide exposure on the nervous system

长期的一氧化二氮(N2O)暴露会导致以脊髓病变为主的神经系统损害,患者一般亚急性起病,进行性加重。临床表现为四肢感觉异常和共济失调,部分患者有周围神经损伤和锥体外系症状,还可能出现认知功能障碍和精神异常。随着近年来N2O滥用相关病例报告增多,研究N2O暴露对神经系统的影响有很大意义。因此,本文通过系统性回顾相关文献和病例报告,分析总结了N2O暴露的损伤机制、临床表现、暴露方式、诊断、治疗及预后等,为临床医师对N2O滥用患者的诊断和治疗提供思路。

Long-term nitrous oxide(N2O)exposure can cause neurological damage mainly manifested as spinal cord lesions.Patients generally have a gradual onset and progressive condition.The clinical manifestations are limb paresthesia and ataxia,some patients have symptoms of peripheral nerve injuries and extrapyramidal tracts injuries,it may cause cognitive dysfunction and mental abnormalities.Since the increase in clinical case reports of N2O abuse,it is of great significance to research the effects of N2O exposure on the nervous system.Therefore,after a systematic review of related literature and case reports,this paper summarizes the injury mechanism,clinical manifestations,exposure methods,diagnosis,treatment and prognosis of N2O exposure.We hope to strengthen the awareness of the disease,and to provide some ideas for diagnosis and treatment.