[1]李晓艳,李远方,贾佳,等.笑气滥用的神经系统损害(附1例报道并文献复习)[J].卒中与神经疾病杂志,2018,25(02):173-178.[doi:10.3969/j.issn.1007-0478.2018.02.013]
　Li Xiaoyan*,Li Yuanfang,Jia Jia,et al.The neurological damage of the abuse oflaughing gas[J].Stroke and Nervous Diseases,2018,25(02):173-178.[doi:10.3969/j.issn.1007-0478.2018.02.013]
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笑气滥用的神经系统损害(附1例报道并文献复习)()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第25卷
期数:
2018年02期
页码:
173-178
栏目:
论 著
出版日期:
2018-04-26

文章信息/Info

Title:
The neurological damage of the abuse oflaughing gas
文章编号:
1007-0478(2018)02-0173-06
作者:
李晓艳; 李远方; 贾佳; 杜鹏; 冯国栋; 金莉蓉
230000 合肥,安徽省第二人民医院神经内科(李晓艳); 复旦大学附属中山医院神经内科[李远方 贾佳 杜鹏 冯国栋 金莉蓉(通信作者)]
Author(s):
Li Xiaoyan*; Li Yuanfang; Jia Jia; et al.
*Department of Neurology,The Second Peoples Hospital of Anhui Province,Hefei 230000
关键词:
笑气 滥用 神经系统 损害
Keywords:
Laughing gas Abuse The nervous system Damage
分类号:
R744 R745
DOI:
10.3969/j.issn.1007-0478.2018.02.013
文献标志码:
A
摘要:
目的 探讨笑气(氧化亚氮)滥用中毒所致的神经系统损害的临床特点。方法 分析1例滥用笑气中毒所致的神经系统损害病例的临床特点及转归。结果 ①笑气中毒所致神经系统病变在临床易被漏诊,以青年多见; ②笑气中毒所致神经系统病变的临床表现为亚急性联合变性样的脊髓损害、以运动轴索损害为主的长度依赖性的周围神经病变以及共济失调等,并常有维生素B12水平下降、高同型半胱氨酸血症; ③磁共振可见颈髓和或胸髓后索呈不规则的白质脱髓鞘,脊髓横断面T2WI显示颈或胸髓后索倒“V”形高信号; ④肌电图主要表现为以运动轴索损害为主的周围神经病变,多以下肢为重。结论 亚急性或慢性起病的青年患者,表现亚急性联合变样、周围神经损害等,需详细询问有无笑气接触史,行血维生素B12、同型半胱氨酸、颈髓磁共振、肌电图等检查,以明确诊断,排除笑气中毒可能。
Abstract:
ObjectiveTo explore the clinical characteristics of the neurological damage caused by the abuse of laughing gas(nitrous oxide).Methods The clinical characteristics and outcome of the nervous system lesions ofa patient abusing laughing gas were retrospectively anaylzed.Results The pathological changes of the nervous system caused by the nitrous oxide were easily missed in the clinic,with the most young people.The laughing gas poisoning resulted in clinical manifestations of nervous system lesions(the spinal cord damage of subacute combined degeneration,in order to exercise axon damage to give priority to the length of the dependence of peripheral neuropathy,and ataxia,and so on),and there was vitamin B12 level drop,high homocysteine levels.Magnetic resonance(MRI)showed the irregular white mass demyelination of the cervical spinal cord and the posterior cord of the thoracic spinal cord,and the T2WI of the spinal cord showed the "V" signal of the neck or thoracic pulp.The main manifestation of the electrogram was the peripheral neuropathy,which was mainly caused by the injury of the motor axon.Conclusion Patients with subacute or chronic onset of youth,performance and change,peripheral nerve damage,and so on,need to ask for details of any contact laughing gas.The blood vitamin B12,homocysteine levels,cervical spinal magnetic resonance and EMG were used to make clear diagnosis,probably ruled out laughing gas poisoning.

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更新日期/Last Update: 2018-04-20