Severe Injuries Associated with Low Voltage Electrical Injuries- Report of Three Cases

高壓電燒傷或雷擊造成的嚴重傷害（如深度燒傷、心肺停止甚至死亡等等）常在文獻中被報告及討論。據統計，低壓電燒傷佔所有電燒傷的三分之二。然而，其造成的嚴重傷害卻很罕見也很少在文獻中提及。我們在這裡報告三個因低壓電燒傷且合併嚴重傷害之病例：個案(1)是一位27歲男性電工被110伏特的交流電電傷，在送到急診室時呈現心肺停止狀態。經施行心肺復甦術及電擊後生命跡象恢復，但腦部核磁共振造影顯示有腦部缺氧之情形。個案(2)是一位34歲男性受到220伏特的交流電電傷，造成右側肩胛骨骨折。個案(3)是一位43歲男性受到220伏特的交流電電傷，造成橫紋肌溶解症及急性腎衰竭。在積極的水分補充及高尿量維持之後，腎功能指數恢復正常。通過這三個個案的分析及相關文獻的參考討論，我們建議即使是被低壓電電傷的病人也可能有合併之嚴重傷害，若有懷疑，應至少住院24小時，期間接受徹底的身體檢查以找出潛在的創傷（如骨折、腎衰竭等）,及必要的實驗室檢查（如心臟監測、腎功能及尿液分析）。

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並列摘要

Severe injuries such as deep thermal burn, cardiopulmonary arrest or immediate death associated with high voltage or lightning electrocution are well reported in the literatures. However, reports of low voltage electrical injuries with severe associated injuries are few. Three cases of low voltage electrical injuries with severe associated injuries were reported. Case 1: A 27-year-old male electrician who suffered from a 110-V electrical injury leading to cardiopulmonary arrest, was dead on arrival (DOA) at the emergency department. After cardiopulmonary resuscitation (CPR), the patient was survived with hypoxic encephalopathy demonstrated in the magnetic resonance imaging (MRI). Case 2: A 34-year-old man who sustained a 220-V electrical injury without fall from height had a fracture of the right scapula. Case 3: A 43-year-old male worker sustained a 220-V electrical injury resulting in a 2(superscript nd)~3(superscript rd) degree burn injury involving 2% of total body surface area (TBSA) with rhabdomyolysis and acute renal failure. The renal function recovered by adequate hydration without hemodialysis. Through the analysis of these cases and literature review, we suggest: (1). Low voltage electrical injuries may have severe associated injuries. For those patients with suspected, associated injuries, they should be admitted at least for 24 hours and thorough physical examinations are indicated. (2). Laboratory tests for myoglobin, creatine phosphokinase (CK), renal function and electrolyte, etc. are warranted. (3). Cardiac and EKG monitoring, CK-MB and troponin testing should be done for patient with potential cardiac injury. (4). Early fluid resuscitation using formula for crush injury and the urinary output maintenance about 300m1/hour for patient with rhabdomyolysis are warranted.

並列關鍵字

low voltage electrical injury ； dead on arrival ； scapular fracture ； rhabdomyolysis ； acute renal failure

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Severe Injuries Associated with Low Voltage Electrical Injuries- Report of Three Cases

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