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职业性接触氯甲酸甲酯致肺损伤成功治疗的病例报告及文献复习

Case report of the successful treatment of lung injury caused by occupational exposure to methyl chloroformate and literature review.

作者信息

Zhao Jiayi, Chai Rong, Han Yiping, Sheng Jing, Bai Chong, Huang Haidong

机构信息

Department of Respiratory and Critical Care Medicine.

Department of Medical Imaging, Changhai Hospital, affiliated to Second Military Medical University, Shanghai, P.R. China.

出版信息

Medicine (Baltimore). 2018 Apr;97(17):e0288. doi: 10.1097/MD.0000000000010288.

DOI:10.1097/MD.0000000000010288
PMID:29702974
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5944481/
Abstract

BACKGROUND

The treatment of acute lung injuries caused by the inhalation of methyl chloroformate remains a difficult clinical problem, with a poor prognosis and a high mortality.

CASE PRESENTATION

After inhalation injuries from methyl chloroformate poisoning, bronchoscopy plays an important role in the diagnosis and treatment of patients. A low tidal air volume and earlier application of steroids are also essential for successful treatment. The grading of acute exposure guideline levels (AEGLs) can direct the selection of a therapeutic regimen for patients with methyl chloroformate poisoning.

CONCLUSIONS

By analyzing the reported acute methyl chloroformate inhalation poisoning cases in China during 1989 to 2017, this study aims to value occupational protection in production activities, accumulate clinical experiences, and provide guidance for the treatment of such cases in the future.

摘要

背景

吸入氯甲酸甲酯所致急性肺损伤的治疗仍是临床难题，预后差，死亡率高。

病例报告

氯甲酸甲酯中毒导致吸入性损伤后，支气管镜检查在患者诊断和治疗中发挥重要作用。低潮气量和早期应用类固醇对成功治疗也至关重要。急性暴露指导水平（AEGLs）分级可指导氯甲酸甲酯中毒患者治疗方案的选择。

结论

通过分析1989年至2017年中国报道的急性氯甲酸甲酯吸入中毒病例，本研究旨在重视生产活动中的职业防护，积累临床经验，并为今后此类病例的治疗提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db98/5944481/3c5933d78dc1/medi-97-e0288-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db98/5944481/3c5933d78dc1/medi-97-e0288-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db98/5944481/59358b2f40c6/medi-97-e0288-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db98/5944481/1c32d73089d1/medi-97-e0288-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db98/5944481/3c5933d78dc1/medi-97-e0288-g007.jpg

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