职业性慢性1-溴丙烷中毒性周围神经病4例临床分析

发布时间：2017-12-31 19:39

本文关键词：职业性慢性1-溴丙烷中毒性周围神经病4例临床分析　出处：《中国职业医学》2016年01期 　论文类型：期刊论文

【摘要】：目的分析职业性慢性1-溴丙烷(1-BP)中毒性周围神经病的临床特点。方法回顾性分析4例职业性慢性1-BP中毒性周围神经病病例的临床资料。结果 4例病例均为某五金真空镀膜企业从事超声波清洗作业的男性工人,在工作中均接触高水平1-BP,接触时间为9~11个月。临床表现主要有不同程度的感觉、运动障碍,主要症状为渐进性加重的肢体麻木、乏力,以下肢多见,可伴有步态不稳。体格检查可见双下肢肌力减弱;双下肢或四肢痛觉和触觉减退,位置觉和振动觉减退;双侧跟腱反射多呈减弱或消失;1例病例出现感觉性共济失调。神经-肌电图检查均存在不同程度的周围神经损害,以运动和感觉神经传导速度减慢多见,且轴索和髓鞘的损害均可见。依据GBZ/T 247—2013《职业性慢性化学物中毒性周围神经病的诊断》,均诊断为职业性慢性1-BP中毒性周围神经病。结论长期接触高水平1-BP可导致以周围神经系统损害为主的慢性中毒,根据1-BP接触史、临床表现和神经-肌电图见神经源性损害可作出诊断。
[Abstract]:Objective to analyze occupational chronic 1-bromopropane (1-BP). Clinical features of toxic peripheral neuropathy. Methods the clinical data of 4 cases of occupational chronic 1-BP toxic peripheral neuropathy were retrospectively analyzed. All the 4 cases were male workers engaged in ultrasonic cleaning in a metal vacuum coating enterprise. All of them were exposed to a high level of 1-BP at work for 9 ~ 11 months. The clinical manifestations were mainly sensory and motor disorders with progressive aggravation of limb numbness and fatigue. The lower extremities were more common, accompanied by gait instability. Physical examination showed that the muscle strength of both lower extremities was weakened. Pain and tactile sensation of lower limbs or limbs were decreased, and position and vibration senses were decreased. The tendon reflex of both sides decreased or disappeared. Sensory ataxia was found in one case. Neuro-electromyogram examination showed peripheral nerve damage to varying degrees, and motor and sensory nerve conduction velocity slowed down. According to GBZ/T 247-2013, "diagnosis of occupational chronic chemical toxic peripheral neuropathy". Conclusion Long-term exposure to high levels of 1-BP can lead to chronic poisoning with peripheral nervous system damage, according to the history of 1-BP exposure. Clinical manifestation and neuromyogram can be diagnosed as neurogenic damage.
【作者单位】：深圳市职业病防治院;广东省职业病防治院广东省职业病防治重点实验室;
【基金】：国家自然科学青年基金(81202245) 深圳市卫生计生系统科研项目(201506075)
【分类号】：R135.14
【正文快照】： 1-溴丙烷(1-bromopropane,1-BP)具有易挥发、不易燃烧、在大气中半衰期短、对大气臭氧层不造成破坏等特点,常被用作三氯乙烯、氯氟烃和1,1,1-三氯乙烷等消耗臭氧层物质的替代品,广泛用于工业生产中[1-3]。国外曾有报道1-BP接触可导致职业中毒,其临床表现以神经系统损害为主[4-

【相似文献】