笑气滥用致神经损害1例

A case of nerve damage caused by nitrous oxide abuse

笑气,化学名一氧化二氮,化学式N2O,是18世纪由英国化学家约瑟夫·普利斯特里首次发现并人工合成。而后Humphrey Davy发现一氧化二氮有麻醉作用,使其在产科及口腔科手术中广为应用。近来的研究表明笑气有镇静、抗焦虑、易复苏的特点,使笑气镇静镇痛技术在儿科手术及烧伤清创换药中有了更多的价值[1-2]。笑气通常是安全的,但当重复使用或长时间应用时,可能会产生严重的副作用。

To explore the clinical characteristics of nervous system damage caused by nitrous oxide abuse,and to improve clinicians’understanding of this disease.The data of a case of nervous system damage caused by nitrous oxide abuse were analyzed and combined with domestic and foreign literatures.The patient suffered from nervous system damage caused by long-term and large amount of nitrous oxide inhalation,which was manifested as the spinal cord damage of subacute combined degeneration,peripheral neuropathy mainly caused by axonal damage,and accompanied by hyperhomocysteinemia.MRI showed that the horizontal spinal cord signal of cervical 2-5 vertebral body was uneven,longitudinal long T2 signal shadow was seen on the dorsal side,and"enhanced inverted V"sign(rabbit ear sign)on the dorsal side of spinal cord was seen on the axial position.The number of patients with nervous system damage caused by nitrous oxide poisoning is increasing.Clinicians should improve their understanding of this kind of disease,and then make early diagnosis and treatment so as to improve the prognosis of patients.