柴油吸入致重症外源性类脂性肺炎并发肺脓肿1例  

One case of severe exogenous lipoid pneumonia complicated with lung abscess caused by diesel inhalation

作　　者：王金霞[1,2] 王彬彬 陈红纲 贺生亮[4] 杨蓉佳[2] 雷丰丰[3] Wang Jinxia;Wang Binbin;Chen Honggang;He Shengliang;Yang Rongjia;Lei Fengfeng(First Clinical Medical School,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Emergency,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Respiratory and Critical Care Medicine,Gansu Provincial Hospital,Lanzhou 73000,China;The First Department of Thoracic Surgery,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院急诊科,兰州730000 [3]甘肃省人民医院呼吸与危重症医学科,兰州730000 [4]甘肃省人民医院胸外一科,兰州730000

出　　处：《中华劳动卫生职业病杂志》2023年第9期695-699,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：外源性类脂性肺炎是一种吸入类脂性物质引起肺部炎性反应,易继发细菌感染,引起局部脓肿形成,严重时可危及生命。本文报道1例55男性患者误吸柴油,继发肺炎克雷伯杆菌(ESBL阳性)及光滑假丝酵母菌感染导致肺脓肿形成,先后进行多种抗菌药物抗感染、无创呼吸机通气、支气管肺泡灌洗、糖皮质激素、化痰等内科治疗效果不佳,最终行肺中叶段切除术好转出院,定期随访恢复良好。Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances,which is prone to secondary bacterial infection,resulting in the formation of local abscesses,which can be life-threatening in severe cases.This paper reports a case of a 55-year-old patient with diesel aspiration,secondary to Klebsiella pneumoniae(ESBL positive)and Candida glabrata infection resulting in lung abscess formation.He was treated with a variety of antibacterial drugs for anti-infection,non-invasive ventilator ventilation,bronchoalveolar lavage,glucocorticoids,phlegm and other medical treatments.Finally,he underwent middle lobectomy for improvement and was discharged from the hospital,and he recovered well with regular follow-up.

关 键 词：肺炎 柴油 外源性类脂性肺炎 支气管肺泡灌洗液 肺炎克雷伯杆菌 肺脓肿 

分 类 号：R563[医药卫生—呼吸系统]