有机氟气体吸入性中毒致急性肺损伤的治疗

目的 总结有机氟气体吸入中毒致急性肺损伤治疗的经验和体会.方法 对11例急性重度有机氟气体吸入中毒致急性肺损伤患者的临床表现、实验室检查,主要治疗措施及治疗后反应进行分析.结果 11例重度中毒患者心、肺、肝、肾、脑等重要生命器官均有不同程度的损害,但肺损伤表现突出.经限制性体液管理,早期足量、中晚期适当延长应用糖皮质激素、双水平气道正压通气联合俯卧位通气等综合治疗,治愈10人,死亡1人,随访1年无1例发生肺纤维化.结论 呼吸支持是治疗重度有机氟气体吸入中毒最为重要的措施,早期无创通气结合俯卧位通气可作为治疗急性中毒性肺水肿的常规抢救措施.

Clinical treatment of acute lung injury induced by organic fluoride poisoning

Objective To summarize the experience about clinical treatment of acute lung injury induced by organic fluoride poisoning. Methods There were 11 cases of acute lung injury induced by severe acute organic fluoride gas inhalation poisoning.Clinical manifestations,laboratory examination,primary treatment and response after treatment were analyzed. Results Heart,lung,liver,kidney,brain and other vital organs were damaged in different degrees in 11 cases of severe poisoning,but lung injury was the most outstanding performance.Clinical therapy included the restrictive fluid management,bi-level positive airway pressure ventilation combined with prone position ventilation.On the early stage,adequate glucocorticoids was used,while on the late stage application time was prolonged.As a result,10 patients were cured and 1 died.No patients presented with pulmonary fibrosis after 1 year tracking. Conclusions Respiratory support is the most important measure in the treatment of severe organic fluorine poisoning.Early noninvasive ventilation combined with prone position ventilation can be conventional measure to treat acute pulmonary edema induced by acute poisoning.