摘要本文报道一起事故中2例由于吸入过量氮气导致的职业性重度中毒性脑病病例。未按有限空间作业相关规章制度执行现场操作和应急救援是造成本起事故的主要原因。缺氧窒息是氮气毒性的主要致病环节，可造成脑水肿，同时，缺氧时可导致细胞内钙环境破坏，加重缺血缺氧。临床病例资料显示2例患者出现以昏迷、四肢肌张力高等以神经系统损害为主的临床表现，亦出现不同程度的肺、心肌和肝肾等损伤，提示治疗要尽早，高压氧疗、积极防治脑水肿、纠正酸中毒、维持水和电解质平衡，抗感染和相应的对症支持疗法是治疗成功的关键。

abstractsThis paper reports two cases of occupational severe toxic encephalopathy caused by inhaling excessive nitrogen in an accident. The main reasons are failure to performing field-work standards of limited space operation and emergency rescue. Hypoxia asphyxia is the main pathogenic link of nitrogen toxicity, which can cause brain edema. At the same time, hypoxia can lead to the destruction of intracellular calcium environment, exacerbating ischemia and hypoxia. Clinical case data shows that 2 cases presented with clinical manifestations mainly including coma, high limb muscle tone, and neurological damage, but also cause different degrees of lung, myocardium, liver and kidney damage. Early treatments, hyperbaric oxygen therapy, active prevention and treatment of brain edema, correction of acidosis, maintenance of water and electrolyte balance, anti-infection and corresponding symptomatic support therapy are key treatments.