六价铬暴露致严重化学性角膜损伤1例

Daisuke Ueno, Yasukazu Shiino, Hisataka Fujimoto, Takahiro Okane, Sachiko Yamada, Jiro Takahashi, Takahiro Inoue
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摘要

眼睛接触六价铬(Cr(VI))酸可导致失明。一名从事电镀作业的42岁男子在工作场所发生事故后被送往急诊室。他不小心掉进了一个装有25% Cr(VI)和硫酸(2.0 g/L)混合物的罐中,温度约为40℃。罐体尺寸为8(深)× 4(宽)× 3(长)米。一名同事将他从水箱中救出,并在工地为他进行了全身清洗。急救人员用0.9%的生理盐水冲洗双眼。他有明显的角膜损伤;然而,没有其他重大伤害发生。在急诊科就诊后,患者接受了全身淋浴,并用0.9%的生理盐水冲洗双眼。为了治疗急性铬中毒,他服用了二巯基丙醇和抗坏血酸。此外,他还接受了眼药水治疗化学性角膜损伤。由于化学角膜损伤,患者后来接受了双侧角膜移植,但仍几乎失明。我们描述了一例严重的角膜化学损伤与角膜缘干细胞缺乏,导致失明,由于铬(VI)酸暴露。
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Severe chemical corneal injury from hexavalent chromium exposure: a case report
Abstract Eye exposure to hexavalent chromium (Cr(VI)) acid can cause blindness. A 42-year-old man working in a plating operation presented to the emergency department following a workplace incident. He had unintentionally fallen into a tank containing a mixture of 25% Cr(VI) and sulfuric acid (2.0 g/L) at a temperature of approximately 40 °C. The tank dimensions tank were 8 (depth) × 4 (width) × 3 (length) meters. A colleague rescued him from the tank, and he underwent a full body wash at the worksite. Emergency services adequately flushed both eyes with a 0.9% saline solution. He had significant corneal injury; however, no other significant injuries occurred. Upon presentation at the emergency department, the patient underwent a whole-body shower, and both eyes were flushed with 0.9% saline solution. As a treatment for acute chromium poisoning, he received dimercaprol and ascorbic acid. Additionally, he received eye drops for chemical corneal injury. The patient later underwent bilateral corneal transplants for chemical corneal injury but remained nearly blind. We describe a case of severe chemical corneal injury with limbal stem cell deficiency, leading to blindness due to Cr (VI) acid exposure.
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