电子烟用液体对人体呼吸系统的影响。1例EVALI患者临床观察

A. I. Mikhailovskiy, V. V. Voytekhovskiy, T. Luchnikova
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引用次数: 0

摘要

的目标。从作者的个人实践论证EVALI的临床观察。材料和方法。简要回顾了有关电子烟液体对人体呼吸系统影响的文献。本文对该病理进行了临床观察。患者H, 19岁,因呼吸短促、咳嗽咯血入住胸外科。在肺实质的计算机断层扫描上,在所有有广泛毛玻璃区域的区域均可见浸润。纤维支气管镜检查示支气管管腔内少量出血性“结痂”及出血性渗出物,为卡他性出血性支气管炎。这名患者是电子烟迷,这一点没有立即引起人们的注意。鉴别诊断为Goodpasture综合征、特发性肺含铁血黄素沉着症、累及肺部的系统性红斑狼疮和anca相关性血管炎。由于有肾病和其他疾病的免疫阴性结果,诊断为Goodpasture综合征。未行肾活检。激素治疗的快速积极动态和没有复发和进展引起了对这种诊断的怀疑。患病后,病人拒绝吸电子烟。再次讨论了记忆,其中有滥用电子烟的迹象,在频繁使用电子烟后出现了详细的疾病临床症状,撤销了good牧草综合征的诊断,肺部损伤被认为是evali的表现。证实电子烟系统的负面影响是所描述的临床病例,表明人类肺损伤和EVALI综合征的鉴别诊断困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of liquids for electronic cigarettes on the human respiratory system. Clinical observation of a patient with EVALI
Aim. Demonstration of clinical observation of EVALI from the personal practice of the authors.Materials and methods. A brief review of the literature on the effects of e-liquids on the human respiratory system is presented. Clinical observation of this pathology is given.Results. Patient H., 19 years old, was admitted to the Thoracic Surgery Department with complaints of shortness of breath, cough with hemoptysis. On computer tomography in lung parenchyma, infiltrates are found in all fields with extensive ground glass areas. Fibrobronchoscopy revealed in the lumen of the bronchi a small amount of hemorrhagic “crusts” and hemorrhagic exudate, catarrhal-hemorrhagic endobronchitis. The patient is a fan of electronic cigarettes, which was not immediately paid attention to. A differential diagnosis was made with Goodpasture's syndrome, idiopathic pulmonary hemosiderosis, systemic lupus erythematosus with lung involvement, and ANCA-associated vasculitis. Since there was nephropathy and there were negative immunological findings of other diseases, a diagnosis of Goodpasture's syndrome was made. A kidney biopsy was not performed. The rapid positive dynamics from hormonal therapy and the absence of relapses and progression raised doubts about this diagnosis. After the disease, the patient refused to take electronic cigarettes. The anamnesis was again addressed, where there were indications of the abuse of electronic cigarettes, after frequent use of which a detailed clinical picture of the disease appeared, the diagnosis of Goodpasture's syndrome was withdrawn, lung damage was regarded as a manifestation of EVALI.Conclusion. Confirmation of the negative impact of electronic smoking systems is the described clinical case, indicating lung damage in humans and difficulties in the differential diagnosis of EVALI syndrome.
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