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內科學誌 Scopus

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篇名 Chlorine Gas Exposure Manifesting Acute Lung Injury
卷期 21:3
並列篇名 氯氣暴露導致急性肺部傷害
作者 侯民波楊振昌張永強劉昌明蔡光超
頁次 210-215
關鍵字 ChlorineLung injurySodium hypochloriteScopusTSCI
出刊日期 201006

中文摘要

在游泳池意外暴露氯氣並非太罕見,且可能因多種狀況產生,譬如氯氣由管路或儲存槽外洩、或不當的沖洗氯化或消毒管線。雖然混合漂白水 (過氯化鈉)及酸液導致之氯氣暴露並非少見的家庭意外事件,但類似的暴露很少發生在遊泳池。吸入氯氣後的臨床表徵可以從輕微的上呼吸道刺激到危及生命的毒性作用,如肺水腫或急性呼吸窘迫症候群。吾人謹報告一起在游泳池發生的因混合過氯化鈉與鹽酸導致的氯氣意外暴露事件。在七名受害者中,有六人呈現呼吸困難、乾咳、及喉嚨與眼睛刺激症狀,經治療後在一天內出院。然而一名15歲的女孩除了產生呼吸道刺激的症狀外,另有缺氧及主要影響右側中、下肺之急性肺傷害。經給予支氣管擴張劑及靜脈注射類固醇後,她於五天後出院。吾人謹討論她的臨床表徵,並回顧現有與氯氣吸入有關之文獻。

英文摘要

Unintentional exposure to chlorine at swimming pools is not uncommon and can occur through various exposure scenarios, such as chlorine leak from pipes or reservoirs, or inappropriate flushing of chlorination/sanitation lines. Although mixing bleach (sodium hypochlorite) with acids accounts for many household chlorine exposure accidents, such an exposure is rare at swimming pools. Clinicalmanifestations of chlorine inhalation can range from mild upper airway irritation to life-threatening toxic effects, such as pulmonary edema/acute respiratory distress syndrome. We reported an incident of chlorine exposure generated from mixing sodium hypochlorite and hydrochloric acid at a swimming pool. Among the 7 victims, 6 presented with dyspnea, dry cough, sore throat and eye irritation. These six patients were discharged within 1 day. A 15-year-old girl however developed hypoxemia and acute lung injury primarily involved right middle and lower lungs in addition to symptoms of airway irritation. She was discharged 5 days later after receiving both bronchodilator and intravenous steroid therapy. Her clinical manifestations were discussed along with a review of existing literature reports on chlorine inhalation.

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