职业性急性二硫化碳中毒病例特点总结

Summary of characteristics of acute carbon disulfide poisoning

目的了解职业性急性二硫化碳中毒病例特点。方法基于CNKI中国学术期刊网络出版总库、万方数字化期刊数据库、Pubmed、Sciencedirect等数据库,收集、筛选国内外职业性急性二硫化碳中毒病例,并将其分为二硫化碳中毒组与二硫化碳、硫化氢混合中毒组,对其临床特征进行总结、分析。结果172例职业性急性二硫化碳中毒患者主要表现为头晕、头痛,恶心、呕吐,乏力,步态蹒跚等症状,检出率分别为94.8%、79.7%、69.8%、41.3%。三颤试验、共济失调阳性率较高,其检出率分别为29.1%、27.9%。辅助检查主要为脑电图异常、心电图异常(心肌缺血),其检出率分别为9.9%,9.3%。二硫化碳中毒组与混合中毒组三颤试验、脑电图检查阳性率差异有统计学意义(P<0.05),其他指标差异无统计学意义(P>0.05)。结论二硫化碳急性中毒可导致中枢神经、心血管系统及周围神经损害,职业性二硫化碳中毒诊断标准有待进一步完善。

Objective To understand the characteristics of occupational acute carbon disulfide poisoning cases.Methods Based on scientific data banks,such as CNKI,Wangfang,Pubmed and Sciencedirect,we collected 172 cases of occupational acute carbon disulfide poisoning in China and abroad,then divided them into two groups,namely,pure carbon disulfide poisoning group and combined poisoning group caused by both carbon disulfide and hydrogen sulfide to summarize and analyze their clinical characteristics.Results Patients with occupational acute carbon disulfide poisoning mainly showed dizziness and headache,nausea and vomiting,fatigue,staggering gait and other symptoms with the detection rate 94.8%,79.7%,69.8%,41.3%,respectively.The positive rates of three tremor test and ataxia were higher,which were 29.1%and 27.9%,respectively.The main clinical examinations were abnormal electroencephalogram and abnormal electrocardiogram(myocardial ischemia),the detection rates were 9.9%and 9.3%,respectively.There was a significant difference in the positive rate of three tremor test and EEG between the pure carbon disulfide poisoning group and the combined poisoning group(P<0.05)and there was no significant difference in other indicators(P>0.05).Conclusions Acute carbon disulfide poisoning can lead to central nervous system,cardiovascular system and peripheral nerve damage.The diagnostic criteria for occupational carbon disulfide poisoning need to be further improved.