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題名 | Acute Respiratory Distress Syndrome Following Cutaneous Exposure to Lysol: A Case Report=皮膚曝露於來沙爾消毒藥水後引發急性呼吸窘迫症候群:一病例報告 |
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作者 | 劉永揚; 盧崇正; 彭瑞鵬; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:12 1999.12[民88.12] |
頁次 | 頁901-906 |
分類號 | 415.47 |
關鍵詞 | 吸收; 急性呼吸窘迫症候群; 來沙爾消毒藥水; 類固醇; Absorption; Acute respiratory distress syndrome; Cresol; Hydrocortisone; Lysol; |
語文 | 英文(English) |
中文摘要 | 來沙爾(Lysol)消毒藥水是我們日常生活常用的一種消毒清潔劑。現在我們報告1例因使用來沙爾消毒藥水不幸導致化學性灼傷而迅速引發急性呼吸衰竭之病例。該病例在本院急診,胸部X光顯示兩側瀰漫性肺浸潤,且動脈血氧體分析發現其在高濃度氧氣治療下呈現反拗性低血氧變化,因此診斷為急性呼吸窘迫症候群。該病患隨後住進加護病房且接受積極的呼吸治療。由於臨床症狀無明顯的改善,故在使用機械通氧輔助後的第7天,我們嘗試使用高劑量的類固醇療法(氫皮質醇30 mg/kg/田。結果發現,臨床上PaO2/FiO2的比率有明顯的改進,然後我們逐漸遞減類固醇的劑量至維持劑量,而該病患也在使用機械通氣輔助後的第93天成功地脫離呼吸器。 |
英文摘要 | Lysol (mixed cresols) is a brand of popular detergent commonly used to disinfect toilets and floors in Taiwan. We report a patient with acute respiratory failure immediately following chemical bums caused by skin contact with Lysol solution. On admission, chest radiography showed bilateral diffuse pulmonary infiltrates and an arterial blood gas analysis disclosed hypoxemia refractory to a high concentration of oxygen by inhalation. Under the impression of acute respiratory distress syndrome, our patient was admitted to the intensive care unit for respiratory care. Poor clinical improvement was noted, despite aggressive respiratory therapy. High-dose steroid therapy (hydrocortisone 30 mg/kg/day) was administered from the seventh day after mechanical ventilation began and the ratio of arterial partial pressure of oxygen to fractional concentration of oxygen in inspired gas improved thereafter. The amount of steroid was gradually tapered to the maintenance dose and the patient was successfully weaned from the ventilator after a 93-day course of mechanical ventilation. |
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