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因砷化物污染河水引起21例砷中毒,就神经系统损害报告如下: 临床资料:本组病人均为居住在被含砷化物工业废水污染的同一条河边的护堤员,均饮用该河水。年龄42～85岁。潜伏期最短半小时,最长8天,一般为2～3天。中毒初期多表现胃肠道症状,如腹痛100％、恶心80.9％、呕吐85.7％、稀水便75.7％或血便28.5％,肝大71.4％,乏力57.9％,食欲不振52.3％,个别病人有浮肿、少尿、声音嘶哑及咳血。神经系统多表现为周围神经炎,如肢端疼痛(38.1％)或感觉异常、末梢性感觉减退85.7％;肢端无力、行走困难(33.3％),少数病人可出现垂足、肌萎缩、鸟爪手、屈曲状强迫姿势等。头晕12例(57.1％)、头痛4例(19％)、视力减退4例(19％),嗅觉障碍2例。本病初期多误诊为急性胃肠炎,待神经系统症状出现后才明确诊断。本组病例治疗101天后,5例测尿砷2例高于正常平均值,15例测发砷13例(86.7％)明显高于正常平均值,有的可高达10～20倍。5个月后测尿砷,20例中仍有6例(30％)高于正常平均值。
Arsenic poisoning caused by river water arsenic poisoning in 21 cases, the report on the damage to the nervous system are as follows: Clinical data: This group of patients are living in the arsenic industrial wastewater contaminated by the same river along the banker, are drinking the river. Age 42 ~ 85 years old. The shortest half-hour incubation period, up to 8 days, usually 2 to 3 days. Early poisoning more gastrointestinal symptoms, such as abdominal pain 100%, nausea, 80.9%, 85.7%, vomiting, 75.7%, or bloody stools 28.5%, 71.4% liver, fatigue 57.9%, loss of appetite 52.3%, individual patients with edema , Oliguria, hoarseness and hemoptysis. Nervous system showed peripheral neuritis, such as acral pain (38.1%) or sensory abnormalities, peripheral sensory decline of 85.7%; limb weakness, walking difficulties (33.3%), a small number of patients may appear foot, muscle atrophy, bird Claw hand, flexion-like posture and so on. Dizziness in 12 cases (57.1%), headache in 4 cases (19%), vision loss in 4 cases (19%), and olfactory dysfunction in 2 cases. Early misdiagnosis of the disease as acute gastroenteritis, nervous system symptoms until after a clear diagnosis. In this group of patients treated 101 days, 5 cases of urinary arsenic in 2 cases higher than the normal average, 15 cases measured arsenic in 13 cases (86.7%) was significantly higher than the normal average, and some up to 10 to 20 times. After 5 months urinary arsenic test, 20 cases are still 6 cases (30%) higher than the normal average.