防水喷雾剂吸入导致化学性肺炎1例  

Chemical pneumonia caused by inhalation of waterproofing spray:a case report

作　　者：李林[1] 石张慧 罗倩 黄玉蓉[1] 李燕明[2] 居阳[2] Li Lin;Shi Zhanghui;Luo Qian;Huang Yurong;Li Yanming;Ju Yang(Department of Pulmonary and Critical Care Medicine,Xinjiang Production and Construction Corps Hospital,Urumqi 830002,China;Department of Pulmonary and Critical Care Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]新疆生产建设兵团医院呼吸与危重症医学科,乌鲁木齐830002 [2]北京医院呼吸与危重症医学科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华结核和呼吸杂志》2024年第11期1106-1108,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：广东省钟南山医学基金会项目(BJ-20220282)。

摘　　要：本文报道1例因防水喷雾剂吸入导致化学性肺炎的患者。患者男,23岁,在封闭空间使用防水喷雾剂喷洒后出现咳嗽、胸闷、发热3 h,白细胞计数12.95×10^(9)/L,中性粒细胞百分比89.3%,C反应蛋白在正常范围。动脉血气分析提示低氧血症,支气管肺泡灌洗液中性粒细胞百分比20.5%,胸部CT表现为双肺弥漫磨玻璃影。给予甲泼尼龙注射液60 mg(1 mg·kg^(-1)·d^(-1))治疗,4 d后气短及咳嗽症状明显缓解,1周后肺部磨玻璃影明显吸收。防水喷雾剂吸入相关化学性肺炎起病急,临床及实验室检查无特异性,需结合病史和支气管镜检查与其他疾病进行鉴别,对糖皮质激素反应良好。This paper described a case of chemical pneumonia caused by inhalation of waterproofing spray.A 23-year-old man presented with a 3-hour history of cough,chest tightness,and fever after using waterproofing spray in a confined space.His peripheral white blood cell count was 12.95×10^(9)/L,with a neutrophil percentage of 89.3%,and his C-reactive protein level was within the normal range.Arterial blood gas analysis showed hypoxemia on room air[PaO 270.4 mmHg(1 mmHg=0.133 kPa)],and bronchoalveolar lavage examination showed a neutrophil percentage of 20.5%.Chest computed tomography showed diffuse ground-glass opacities in both lungs.He was treated with intravenous methylprednisolone 60 mg(1 mg·kg^(-1)·d^(-1))daily.The symptoms of shortness of breath and cough improved significantly with a four-day course of methylprednisolone,and the ground-glass opacities in the lungs largely resolved after one week of methylprednisolone.Chemical pneumonia caused by inhalation of waterproofing spray has an acute onset with non-specific clinical and laboratory findings.It should be differentiated from other diseases by a combination of medical history and bronchoscopy,and it responds well to treatment with glucocorticoids.

关 键 词：化学性肺炎 支气管镜检查 动脉血气分析 低氧血症 咳嗽症状 磨玻璃影 白细胞计数 喷雾剂 

分 类 号：R563.1[医药卫生—呼吸系统]