An Unusual Case of Cardiac Injury Complicating Traumatic Asphyxia: A Case Report

創傷性窒息併發心臟損傷：病例報告

陳冠良(Kuan-Liang Chen) ； 曹明正(Ming-Cheng Tsao) ； 郭獻源(Xian-Yuan Guo)

《南臺灣醫學雜誌》 15卷2期 (2019/12) Pp. 109-115

https://doi.org/10.6726/MJST.201912_15(2).0005

摘要

Traumatic asphyxiais an uncommon syndrome taking place after a severe crushing to the chest preceded by deep inspiration. The prognosis is good but prolonged thoracic compression can lead to cerebral hypoxia and neurological sequelae. We report a 30-year-old asian male was accidentally squeezing by comforter packing machine on the chest for 5 minutes. Because of conscious disturbance and impending respiratory failure, our patient was urgently intubated with subsequent mechanical ventilation. Physical exam showed subconjunctival hemorrhages, ou, exophthalmos, ou,face and neck congestion, edematous and covered with numerous petechiae on the chest and abdominal wall. Chest CT (computed tomography) exam showed right 4,5th ribs fracture with mild hemothorax without internal abdominal bleeding or pericardial effusion. Electrocardiogram was normal. Serum biochemistry showed elevated cardiac enzyme and. Echocardiography revealed generalized left ventricular hypokinesia. After well intensive care unit monitoring and management, the patient was transfer to general ward on the 6th hospital day.

關鍵字

traumatic asphyxia ； cardiac injury ； neurologic sequelae

並列摘要

創傷性窒息是一種罕見的綜合症，發生在深度吸氣狀態下嚴重擠壓胸壁受創而產生。預後良好，但長時間的胸廓壓迫可導致腦缺氧和神經系統後遺症。我們報告了一名30歲的亞洲男性被被子包裝機擠壓胸部5分鐘。由於意識障礙和即將發生的呼吸衰竭，我們給予緊急插管並隨後以呼吸器維持通氣。理學檢查顯示雙側結膜下出血，雙側眼球突出，面部和頸部充血水腫，胸部和腹壁上有許多瘀點。胸部CT檢查顯示右側第4、5肋骨骨折伴有輕度血胸，無內部腹腔出血或心包積液。心電圖正常。血清生化顯示心肌酶升高和心臟超音波顯示左心室運動功能不良。在重症監護室監測和管理後，患者在第6個住院日轉至普通病房。

並列關鍵字

創傷性窒息 ； 心臟損傷 ； 神經系統後遺症