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我院于1985～1996年共收治急性有机磷农药中毒患者712例,其中发生迟发性周围神经病变15例,现报道如下。1 临床资料1.1 一般资料 本组女12例,男3例。年龄18～65岁。口服中毒12例,接触中毒3例,其中毒物为甲胺磷6例,敌敌畏4例,乐果3例,1605、敌百虫各1例。中毒程度;重度11例,轻、中度4例。发生迟发性周围神经病变的时间为中毒症状消失后3～28天。1.2 临床表现 15例均表现为肢体远端对称性的下运动神经元性瘫痪,且运动障碍较感觉损害明显,下肢损害比上肢严重.四肢远端麻木14例,蚁行感5例,痛觉过敏2例,皮肤烧灼感1例,四肢肌张力减低11例,膝反射减弱10例,踝反射减弱或消失9例,肱二、三头肌反射减弱8例,大小鱼际肌和骨间肌萎缩7例,腓肠肌萎缩6例,皮肤发凉感3例。1.3 肌电图检查15例中7例拇短展肌、小指展肌,8例胫前肌出现纤颤电位,肌肉轻度收缩时运动多相电位增多.10例正中尺神经的肘-腕段及10例腓总神经的膝-踝段运动神经传导速度减慢。
Our hospital in 1985 to 1996 were treated 712 cases of acute organophosphorus pesticide poisoning in patients, of which 15 cases of delayed peripheral neuropathy occur, are reported below. 1 Clinical data 1.1 General Information The group of female 12 cases, 3 males. Age 18 ~ 65 years old. Oral poisoning in 12 cases, exposure to poisoning in 3 cases, including poisoning methamidophos 6 cases, dichlorvos in 4 cases, 3 cases of dimethoate, 1605, trichlorfon in 1 case. Toxicity; severe in 11 cases, mild and moderate in 4 cases. The occurrence of delayed peripheral neuropathy time is 3 to 28 days after the symptoms disappear. 1.2 Clinical manifestations of 15 cases showed distal symmetry of the lower motor neuron paralysis, and dyskinesia than the sensory damage significantly lower extremity damage than upper limbs limbs distal numbness in 14 cases, ant row sensation in 5 cases, hyperalgesia 2 cases, burning sensation in 1 case, decreased limb muscle tension in 11 cases, decreased knee reflex in 10 cases, decreased or disappeared ankle in 9 cases, brachial and triceps reflex decreased in 8 cases, the size of the atresia and interosseous muscle atrophy 7 cases, 6 cases of gastrocnemius atrophy, 3 cases of cold feeling in the skin. 1.3 EMG examination in 15 cases, 7 cases of abductor hallucistes, the little finger abductor muscles, 8 cases of tibialis anterior fibrillation potential, muscle mild contraction increased motor multiphase potentials .10 cases of median ulnar nerve elbow - wrist segment And 10 cases of peroneal nerve knee-ankle motor nerve conduction slowed down.