目的 探讨经颅彩色多普勒超声（Transcranial Color-Code Sonography，TCCS）在急性甲苯、二甲苯中毒诊断中的临 床价值。方法 选取2013年5月至2018年5月间于我院就诊的急性甲苯、二甲苯中毒患者55例作为观察组，其中轻度中毒患者 34例，中度中毒患者21例；另选取同期接受TCCS检查且非接触甲苯、二甲苯的健康正常成年人50例作为对照组；所有研 究对象均接受TCCS检查，观察组入院后行急诊头颅CT、MRI检查。对比观察组、对照组TCCS检查结果，分析观察组患者 头颅CT、MRI诊断结果。结果 入院时中毒患者MCA血流参数指标与对照组比较存在显著差异（P<0.05），中度中毒患者 MCA血流参数Vp、Vd、Vm明显高于轻度中毒患者，PI、RI水平明显低于轻度中毒患者（P<0.05）。治疗后轻度、中度中 毒患者MCA血流参数较入院时明显改善，与对照组比较无显著差异（P>0.05）。入院时影像学检查结果显示，轻、中度中 毒患者TCCS检查阳性率明显高于CT、MRI异常的阳性率（P<0.05）。结论 通过对MCA血流参数的评估，经颅彩色多普勒 超声可及时发现急性甲苯、二甲苯中毒时颅内血流动力学的改变，为其早期、准确诊断提供可靠依据，较螺旋CT、MRI具 有更高的敏感性，具有临床诊断价值。

Objective To investigate the clinical value of transcranial color-code sonography (TCCS) in the diagnosis of acute toluene and xylene poisoning. Methods A total of 55 patients with acute toluene and xylene poisoning admitted to our hospital from May 2013 to May 2018 were selected as observation group, including 34 patients with mild poisoning and 21 patients with moderate poisoning. Another 50 healthy adults were selected as control group. All subjects underwent TCCS examination. The observation group underwent CT and MRI examinations after admission. The results of TCCS examination in observation group and control group were compared, and the diagnostic results of CT and MRI in observation group were analyzed. Results There were significant differences in MCA blood flow parameters between the intoxicated patients and the control group at admission (P<0.05). The blood flow parameters Vp, Vd and Vm of MCA in moderate poisoning patients were significantly higher than those in mild poisoning patients, and the levels of PI and RI were significantly lower than those in mild poisoning patients (P<0.05). After treatment, MCA blood flow parameters of mild and moderate poisoning patients were significantly improved compared with those at admission, and there was no significant difference compared with the control group (P>0.05). The results of imaging examination at admission showed that the positive rate of TCCS in mild and moderate poisoning patients was significantly higher than that of abnormal CT and MRI (P<0.05). Conclusion Through the assessment of MCA blood flow parameters, TCCS can detect the changes of hemodynamics in acute toluene and xylene poisoning, and provide reliable evidence for early and accurate diagnosis. It is more sensitive than spiral CT and MRI, and has clinical diagnostic value.