Ger J, Huang Y S, Yao C, Lin W L, Deng J F
Division of Clinical Toxicology, Taipei Veterans General Hospital.
Zhonghua Yi Xue Za Zhi (Taipei). 1993 Aug;52(2):132-6.
Chemical hepatic injury is not rare in Taiwan. We here report such an injury induced by chloroform. A previously healthy 26-year-old married woman was admitted under the impression of acute chemical hepatitis in December, 1991. Two weeks before, she had used chloroform as glue to unite two pieces of plastic pencil sharpener at home. Nasty odor was sensed while working. After series of hepatitis workup, liver echo, site visit, survey of coworkers and gas chromatography for the "glue", the diagnosis of chloroform-induced hepatic injury was confirmed. This case found that neither employer nor employee was aware of the toxicity of chloroform. No ventilation system or personal respiratory protection equipment was provided. Preemployment training and Material Safety Data Sheet were obviously insufficient, also. The diagnostic criteria of chemical hepatic injury were therefore proposed to alert medical professionals, industrial hygienist, safety personnel and factory inspectors, not to prompt an early diagnosis but also hopefully to prevent the occurrence of occupational liver diseases.
化学性肝损伤在台湾并不罕见。我们在此报告一例由氯仿引起的此类损伤。一名既往健康的26岁已婚女性于1991年12月因急性化学性肝炎入院。两周前，她在家中使用氯仿作为胶水来拼接两片塑料卷笔刀。工作时闻到了刺鼻气味。经过一系列肝脏检查、肝脏超声、现场走访、对同事的调查以及对“胶水”进行气相色谱分析后，确诊为氯仿所致肝损伤。该病例发现雇主和雇员均未意识到氯仿的毒性。未提供通风系统或个人呼吸防护设备。岗前培训和材料安全数据表也明显不足。因此提出化学性肝损伤的诊断标准，以提醒医学专业人员、工业卫生学家、安全人员和工厂检查员，不仅要促进早期诊断，还希望预防职业性肝病的发生。
