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慢性职业性止己烷中毒患者神经-肌电图表现特征分析
引用本文:赵乾魁,傅绪珍,李思惠,周元陵,周志俊. 慢性职业性止己烷中毒患者神经-肌电图表现特征分析[J]. 环境与职业医学, 2011, 28(2): 68-72
作者姓名:赵乾魁  傅绪珍  李思惠  周元陵  周志俊
作者单位:赵乾魁,ZHAO Qian-kui(复旦大学附属金山医院,上海,200540;复大学公共卫生学院,教育部公共卫生安全重点实验室,上海,200032);傅绪珍,李思惠,FU Xu-zhen,LI Si-hui(上海市化工职业病防治院,上海,200030);周元陵,ZHOU Yuan-ling(复旦大学附属金山医院,上海,200540);周志俊,ZHOU Zhi-jun(复大学公共卫生学院,教育部公共卫生安全重点实验室,上海,200032)
基金项目:国家"十一五"科技支撑计划任务,上海市公共卫生重点学科建设计划
摘    要:
[目的]分析职业性正己烷中毒患者神经肌电图表现的特征,明确肌电图表现改变在正己烷中毒诊断中的作用。[方法]对某电子企业2009年9名正己烷中毒患者进行深度调查,收集工人的职业吏并对接触毒物进行鉴定,所有患者进行神经专科检查和定期神经肌电图检查,观察中毒患者神经肌电表现的特征。[结果]9例患者都有确切的正己烷接触史,神经电生理检查显示肌肉自发电位增多,收缩时相位异常,神经传导速度下降(P〈0.01).远端潜伏期延长(P〈0.01),波幅下降(P〈0.05o经营养神经对症处理辅以运动锻炼治疗后9例患者均有好转(P〈0.05o[结论]正己烷慢性中毒患者神经肌电图表现为周围神经受损,运动神经较感觉神经严重,入院治疗后临床症状好转先于神经肌电图改变,在评价恢复程度时应更注重临床表现而不导神终肌电检查。

关 键 词:正己烷  中毒  周围神经损害  神经肌电图

Analysis on Electroneuromyographic Characteristics of Chronic Occupational N-hexane Poisoning Cases
ZHAO Qian-kui,FU Xu-zhen,LI Si-hui,ZHOU Yuan-ling,ZHOU Zhi-jun. Analysis on Electroneuromyographic Characteristics of Chronic Occupational N-hexane Poisoning Cases[J]. Journal of Environmental & Occupational Medicine, 2011, 28(2): 68-72
Authors:ZHAO Qian-kui  FU Xu-zhen  LI Si-hui  ZHOU Yuan-ling  ZHOU Zhi-jun
Affiliation:^3 ( 1.Jinshan Hospital Affliliated to Fudan University, Shanghai 200540, China; 2.Shanghai Institute of Chemical Industrial Occupational Disease Prevention and Treatment, Shanghai 200030, China; 3.School of Public Health/ National Key Lab for Public Health Safety of Ministry of Health, Fudan University, Shanghai 200032, China ).Address correspondence to ZHOU Yuan-ling; E-mail: zhouyl2OOO@yahoo.com.cn)
Abstract:
To analyze the characteristics of electroneuromyography( ENMG )of chronic occupational n-hexane poisoning cases, and to define the role of ENMG in n-hexane poisoning diagnosis. I Methods I Nine n-hexane poisoning patients admitted into a hospital in April 2009 were investigated thouroughly, all the clinical and occupational history were collected, neurological examination and ENMG were taken periodically, and the exposed toxicant at workplace was identified. [ Results ] The 9 cases were identified as having been exposed to n-hexane and their ENMG showed increased muscle spontaneous potential, abnormal phase emerged in muscle contraction, decreased nerve conduction velocity( P 〈 0.01 ), extended distal latency( P 〈 0.01 ), and decreased wave amplitude( P 〈 0.05 ). After trophie treatment on nerve together with physical exercise, the status of illness was greatly improved. [ Conclusion ] ENMG in chronic occupational n-hexane poisoning cases showed peripheral nerve injury, and the motor nerves were more vulnerable than the sensory nerves. Clinical recovery preceded the improvements of ENMG. It should be more focused on clinical recovery rather than manifestations of ENMG in the evaluation of restoring health.
Keywords:n-hexane  poisoning  peripheral nerve injury  electroneuromyography
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