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氩气中毒导致持续性记忆损伤:2 年病例报告。

Argon gas poisoning leading to persistent memory impairment: A 2-year case report.

机构信息

Department of Neurology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

Department of Neurology, Jimusaer County People's Hospital, China.

出版信息

Medicine (Baltimore). 2024 Jun 14;103(24):e38545. doi: 10.1097/MD.0000000000038545.

Abstract

RATIONALE

Argon gas poisoning is an often overlooked yet critical public health concern with the potential for severe and persistent neurological consequences. Current treatment protocols primarily focus on acute-phase management, but a comprehensive understanding of the long-term neurological effects remains incomplete.

PATIENT CONCERNS

A 22-year-old male worker was found unconscious in the furnace room of an argon production facility. After regaining consciousness, he presented with symptoms of dizziness, headache, fatigue, and irritability. Neurological examination revealed impairments in both recent and remote memory, notably pronounced short-term memory deficits and reduced arithmetic skills.

DIAGNOSIS

Argon gas poisoning, hypoxic encephalopathy, and mild hepatic and renal dysfunction.

INTERVENTIONS

Upon admission, symptomatic supportive measures included oxygen therapy via nasal cannula (3 L/min), daily hyperbaric oxygen therapy (1.5 ATA, 60 minutes), oral neurotrophic methylcobalamin (0.5 mg, 3 times daily), and intravenous vitamin C infusion (2 g daily) to scavenge oxygen free radicals.

OUTCOME

A 2-year telephone follow-up indicated persistent short-term memory impairment, particularly with memorizing numbers. In a memory test, he achieved a digit span forward of 5 but a digit span backward of 2, indicating impairment. Despite these challenges, his daily life and work performance remained largely unaffected.

LESSON

This case offers valuable insights into the biological mechanisms underlying prolonged neurological sequelae following asphyxiating gas exposure, specifically the persistent impairment of hippocampal function.

摘要

背景

氩气中毒是一个经常被忽视但又至关重要的公共卫生问题,可能会导致严重且持久的神经后果。目前的治疗方案主要集中在急性期管理,但对长期神经影响的全面了解仍不完整。

病例报告

一名 22 岁男性工人在氩气生产设施的炉膛室内被发现失去意识。苏醒后,他出现头晕、头痛、疲劳和易怒等症状。神经系统检查显示近期和远期记忆受损,特别是明显的短期记忆缺陷和计算能力下降。

诊断

氩气中毒、低氧性脑病和轻度肝肾功能障碍。

干预措施

入院后,给予对症支持治疗,包括经鼻导管吸氧(3L/min)、每日高压氧治疗(1.5ATA,60 分钟)、口服神经营养甲基钴胺素(0.5mg,每日 3 次)和静脉注射维生素 C 输注(2g 每日)以清除氧自由基。

结果

2 年电话随访显示持续存在短期记忆障碍,特别是在记忆数字方面。在记忆测试中,他的数字跨度前向为 5,但数字跨度后向为 2,表明存在障碍。尽管存在这些挑战,但他的日常生活和工作表现基本未受影响。

结论

该病例提供了关于窒息性气体暴露后长期神经后遗症的生物学机制的宝贵见解,特别是海马功能持续受损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c59/11175893/9c0eb155d52a/medi-103-e38545-g001.jpg

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