Levent ÖZDEMİR, Feride KARACAER, Burcu ÖZDEMİR, Ardanur KARADAL

KLOR GAZI İNHALASYONLU OLGULARIMIZ

Acil servise klor gazı inhalasyonu na maruziyet sonrası gelen hastaların şikayetleri, klinik-laboratuvar bulguları ve tedavileri değerlendirildi. Ekim 2010’da Dörtyol Devlet Hastanesi acil servisine fabrikada klor tankı bakımı sırasında ortama yayılan klor gazına maruz kalan 8 hastanın şikayetleri, fizik muayene bulguları, arter kan gazları, akciğer grafileri ve uygulanan tedaviler prospektif olarak değerlendirildi. Yaş ortalaması 26.5±4.9 olan 6’sı erkek 8 hastanın 5’i gözlem sonrası taburcu edilirken, 3 hasta yoğun bakımda gözleme alınarak takip ve tedavi edildi. Başvuru sırasında tüm olgularda öksürük, 4 olguda nefes darlığı, hırıltı ve göğüs ağrısı, 2 olguda gözde ve boğazda yanma hissi, 1 olguda da başağrısı mevcuttu. Olguların ortalama sistolik arter basıncı değeri 108.3±16.3 mm-Hg, diastolik arter basıncı değeri ise 64.6±8.9 mm-Hg idi. Ortalama nabız 76.5±18.5/dk olarak bulundu. Dakika solunum sayısı:19±4.2 idi. Arteriyel kan gazı değerleri PH: 7.40, PO2: 85.1±22.4, PCO2: 33.1±3.3, HCO3: 20.8±2.9, Sat%O2: 95.3±3.7, A-a gradient: 25.7±14.3 idi. Solunum sistemi oskültasyonunda, 4 olguda ronküs-ekspiryumda uzama mevcuttu. Hastaların akciğer grafilerinde patoloji saptanmadı. Hastaların 4’üne oksijen ve steroid, 4’üne oksijen, steroid, bronkodilatatör tedavisi verildi. Klinik takibinde 1 hastada reaktif havayolu disfonksiyonu (RADS) geliştiği saptandı. Klor gazı inhalasyonu sık gözlenmekle birlikte solunum yollarında hafif düzeyde etkilenme yaratacağı gibi, daha şiddetli maruziyetlerde RADS gelişimine de neden olabilir.

We determined the complaints, clinical and laboratory results and therapy of cases of chlorine gas inhalation in emergency department 8 Chlorine gas inhalation cases who exposured to chlorine gas in factory tank care, admitted to Dörtyol Goverment Hospital emergency department october 2010 were evaluted prospectively, complaints, phsical examination signs, arterial blood gases, lung-X ray results and treatment modolities were evaluted Mean age of the cases was 26.5±4.9, 6 of cases were men. 5 cases were discharged after observation. 3 cases were observed and treated in intensity care service. There was coughing in all cases, dsypne wheezing and chest pain in 4 cases, burning sensation in the throat and eye in 2 cases, headache in 1 case. Mean systolic arterial pressure of case was 108.3±16.3 mm-Hg, mean diastolic arterial pressure was ise 64.6±8.9 mmHg, mean pulse rate was 76.5±18.5/minutes, minute respiratory rate was 19±4.2, Arterial blood gases results were PH:7,40, PO2: 85.1±22.4, PCO2: 33.1±3.3, HCO3: 20.8±2.9, Sat%O2: 95.3±3.7, A-a gradient: 25.7±14.3. Ronchus and long expiration time was determined in 4 cases, lung-X ray of case were normal, 4 case were treated by oxygen and steroid, 4 cases were treated by oxygen, steroid and bronchodilatator. RADS was estabilished in 1 case. Chlorine gas inhalation can seen common and may affect the airways mildly or way case more severe clinical outcames as RADS.

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