摘要
由於直接吸入氣溶膠或吸入液體柴油會導致嚴重的化學性肺炎甚至急性呼吸窘迫症候群。通過嘔吐物間接攝入柴油也可導致誤吸。本病例報告描述了一名 57 歲的男性患者他在從油箱中抽取柴油時不慎被柴油窒息，出現胸部不適，呼吸急促和發冷的症狀。到達急診室後，患者被診斷為吸入性肺炎和急性呼吸衰竭。不幸的是，這名患者的病情在兩天后惡化，他隨後發展為急性呼吸窘迫症候群。值得慶幸的是，患者倖免於難，並成功脫離了呼吸器。然而，患者後續出現了肺纖維化的後遺症。該病例強調了考慮肺炎患者詳細職業暴露史的重要性。確定任何潛在的有害物質暴露至關重要，尤其是在涉及化學品或燃料的行業工作的患者中。早期識別和管理吸入性肺炎，對於預防嚴重併發症，如急性呼吸窘迫症候群的發展至關重要。此外，需要長期監測可能出現的任何延遲後遺症。
關鍵詞：柴油吸入、急性呼吸窘迫症候群、肺纖維化
Abstract
Diesel fuel inhalation can cause severe chemical pneumonitis or acute respiratory distress syndrome (ARDS) through direct inhalation of aerosol or aspiration of liquid diesel. Indirect ingestion of diesel oil through vomitus can also lead to aspiration. This case report describes a 57-year-old male patient with chest discomfort, shortness of breath, and chills after accidentally choking on diesel fuel while siphoning it from a tank. Upon arriving at the Emergency Room, the patient was diagnosed with aspiration pneumonitis and acute respiratory failure. Unfortunately, the patient’s condition worsened two days later, and he developed ARDS. The patient survived the episode and was successfully weaned off the ventilator. However, the patient did develop pulmonary fibrosis as a sequelae. This case emphasizes the importance of considering a detailed occupational exposure history in patients with pneumonia. Identifying any potential exposure to harmful substances is crucial, especially in patients who work in industries involving chemicals or fuels. Early recognition and management of aspiration pneumonitis are essential to prevent the development of severe complications such as ARDS. In addition, long-term follow-up is necessary to monitor for any delayed sequelae that may arise.
Keywords: Diesel fuel inhalation, Acute respiratory distress syndrome, Pulmonary fibrosis