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大麻素油蒸气吸入相关性肺损伤及其影像学表现。

Cannabinoid Oil Vaping-Associated Lung Injury and its Radiographic Appearance.

机构信息

Division of Pulmonary and Critical Care Medicine.

Division of Radiology, Albany Medical College, NY.

出版信息

Am J Med. 2020 Jul;133(7):865-867. doi: 10.1016/j.amjmed.2019.10.032. Epub 2019 Nov 18.

Abstract

BACKGROUND

Lung injury associated with cannabinoid oil vaping is rapidly becoming a serious public health concern. We describe the clinical and radiographic presentations of 5 patients with lung injury associated with vaping cannabinoid oils seen at a single institution.

RESULTS

Of the 5 patients with suspected vaping-associated lung injury seen at our institution, 4 required supplemental oxygen, and all these 4 were admitted to the hospital. Three patients required admission to the intensive care unit. None of the patients required mechanical ventilation. All patients demonstrated a consistent radiologic appearance of diffuse bilateral ground-glass lung opacities that spared the extreme periphery. Three patients underwent bronchoalveolar lavage, which revealed lipid-laden macrophages in 2 of them. All patients were successfully discharged from the hospital. Four received only supportive care, while the fifth required intravenous followed by oral corticosteroids.

CONCLUSIONS

We report the clinical and radiographic presentation of 5 patients at our institution with cannabinoid oil vaping-associated lung injury. All patients displayed a consistent chest radiographic pattern of injury. Most responded to supportive care, although one required the addition of corticosteroids. Bronchoalveolar lavage results suggest that this injury may related to a toxic form of lipoid pneumonia.

摘要

背景

与吸食大麻油相关的肺损伤迅速成为一个严重的公共卫生关注点。我们描述了在一家机构就诊的 5 例与吸食大麻油相关的肺损伤患者的临床和影像学表现。

结果

在我们机构就诊的 5 例疑似与吸食大麻油相关的肺损伤患者中,4 例需要补充氧气,这 4 例均住院治疗。3 例患者需要入住重症监护病房。所有患者均未需要机械通气。所有患者的影像学表现均为弥漫性双侧磨玻璃影,不累及外周极端部位,表现一致。3 例患者接受了支气管肺泡灌洗,其中 2 例显示含脂巨噬细胞。所有患者均成功出院。4 例仅接受了支持性治疗,而第 5 例则需要静脉和口服皮质类固醇治疗。

结论

我们报告了在我们机构就诊的 5 例与吸食大麻油相关的肺损伤患者的临床和影像学表现。所有患者的胸部 X 线表现一致。尽管有 1 例需要加用皮质类固醇,但大多数患者对支持性治疗有反应。支气管肺泡灌洗结果提示这种损伤可能与脂质性肺炎的一种中毒形式有关。

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