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我所先后收治重度丙烯酰胺中毒患者5例,现将其病程中一些有特点的表现报告如下:1 临床资料 5位患者均为小型化工厂工人,从事丙烯酰胺助剂生产,由于厂方和工人均对丙烯酰胺毒性缺乏认识,工作中不注重防护,不带手套直接接触丙烯酰胺,无下班后洗浴设施,甚至吃饭时亦常常不洗手,皮肤沾染有大量丙烯酰胺。患者均为男性,年龄18~27岁,接触丙烯酰胺工龄1.5~2个月。患者病史中除具有双手麻木、多汗、脱皮、感觉减退、持物不稳、反应迟钝、记忆减退外,均有明显嗜睡及小脑功能障碍,如言语含糊,指鼻及跟膝胫试验不稳,轮替动作失调,闭目站立不稳,步态蹒跚等。根据《职业性丙烯酰胺中毒诊断标准及处理原则》GB16730—1996,诊断为重度丙烯酰胺中毒。经应用胞二磷胆碱、乙酰谷酰胺、能量合剂、多种维生素、脑复新等药物,配合对症治疗、理疗、功能锻炼等措施进行治疗,均治愈。以下为患者病史中一些有特点的表现:
I have treated severe 5 cases of patients with acrylamide poisoning, and now some of its performance in the course of the performance report is as follows: 1 Clinical data 5 patients are small-scale chemical plant workers engaged in the production of acrylamide additives, the factory and workers Per capita lack of understanding of the toxicity of acrylamide, work does not pay attention to protection, without gloves direct exposure to acrylamide, bath facilities after get off work, and often do not wash your hands often, the skin contaminated with a large number of acrylamide. Patients were male, aged 18 to 27 years, exposure to acrylamide 1.5 to 2 months of age. Patients with history of numbness, sweating, peeling, sensory decline, persistent instability, unresponsiveness, memory loss, there are significant lethargy and cerebellar dysfunction, such as verbal ambiguity, finger nose and knee tibia test instability, Rotational disorder, turn a blind eye standstill, hobbled gait and so on. According to the “diagnostic criteria for occupational acrylamide poisoning and treatment principle” GB16730-1996, diagnosed as severe acrylamide poisoning. The application of citicoline, acetyl glutamine, energy mixture, a variety of vitamins, brain rehabilitation and other drugs, with symptomatic treatment, physical therapy, functional exercise and other measures for treatment, were cured. The following are some of the characteristics of the patient’s medical history: