急性二氯乙烷中毒 Acute occupational 1,2-dichloroethane poisoning.ppt

Acute occupational 1,2-dichloroethane(1,2-DCE) poisoning General Profile Application and Exposure： Widely use in electronics manufacture, shoes manufacture, ，Industrial production, such as rubber , resin, paint, synthetic fiber and vinyl-chloride ,ect. General Profile Mechanism of Poisoning ： Attack induced by increasing free radicals Cells suffocation induced by interference to the metabolism of brain cells Brain edema type: vasogenic cerebral edema (at first), mixed cerebral edema (mainly); Cause acute and subacute poisoning epidemic types: sporadic ,seldom outbreak Widespread brain damage that involves the whole brain,especially in the cerebellum and extrapyramidal Brain edema last a long period and often occur repeatedly; A few patient can have secondary epilepsy May be accompanied by liver, kidney and heart damage. Case introduction Female，46y， worker of a shoes factory Occupational history ： 2009.06—2010.01, Shoes modeling (放港宝), attach shoe materials, exposed to thinners (banana oil) 。 Working 10~12h/day, in a small house with windows closed in cold winter, no fresh air， No mask or other protective equipments, one more worker in the same position. Walkthrough investigation: 2010.01.09-12, Result of Air Test in modeling workshop: Max concentration of 1,2-DCE 7.4mg/m3。 Result of material analysis : 1,2-DCE can be found in thinners (banana oil) Chief? complaint: Headache for 9 days with limb convulsion for 8 days History? of? present?? illness: 2010.01.04 had progressive headache with nausea 2010.01.05 had severe headache and vomit after lunch took some pills for cold by herself , but still got worse develop to aphasia and limb convulsion limb convulsion shook her twice in an hour, 10-60 seconds every time . With lost consciousness, eyes on the turn , limb stiffness. Sent to general hospital but continued getting worse, limb convulsion occurred more often with the longer lasting time. . 2010.01.08 Transferred to the In