每日一题_2025.06.26

A 23-year-old man presented to an outpatient health center with a 2-day history of painful swallowing and hoarseness. The symptoms developed after he had inhaled nitrous oxide through his mouth from a hand-held canister for recreation. Physical examination was notable for erythema, swelling, and sloughing of the mucosa on the soft palate, uvula, and posterior oropharynx. There was no increased work of breathing or stridor. Flexible nasolaryngoscopy revealed a small area of ulceration and swelling on the right vocal fold. What is the most likely diagnosis?

一名23岁男性因吞咽疼痛和声音嘶哑2天就诊于门诊健康中心。这些症状是在他为了娱乐目的通过手持罐从口中吸入一氧化二氮（俗称“笑气”）后出现的。体格检查发现软腭、悬雍垂及口咽后壁黏膜出现红斑、肿胀及黏膜脱落。无呼吸费力或喘鸣表现。纤维鼻咽喉镜检查显示右侧声带有一小片溃疡及肿胀。最可能的诊断是什么？

A. Chemical mucositis化学性黏膜炎

B. Frostbite injury冻伤

C. Hypersensitivity reaction超敏反应

D. Oropharyngeal candidiasis口咽念珠菌病

E. Thermal injury热力损伤

答案解析：

因吸入一氧化二氮导致的冻伤。这种在娱乐性使用时被称为”笑气”或”whippets”的一氧化二氮气体，是以液态形式储存在加压罐中的。当气体从罐中释放时，无论是气体本身还是罐体表面都会迅速降温，可能造成接触性冻伤。

正确答案：B