在儿科患者中,急性大规模上部胃肠道出血的多学科治疗是由于烧伤后压力的次要原因:一个病例报告
Yangping Wang1, Yong Yang2, Ziqin Shu1
1State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
严重的烧伤会导致儿童患有危险的胃肠道出血. 胃镜和栓塞的结合成功治疗了一名患有严重烧伤后出血的儿科患者,提供了有价值的临床参考.
科学领域:
- 胃肠病学 胃肠病学
- 儿科手术 儿科手术
- 干预性放射学 干预性放射学
背景情况:
- 严重的烧伤可能导致胃和十二指肠侵蚀和,可能导致危及生命的出血.
- 目前治疗烧伤后胃肠道出血的方法包括药物治疗和内镜检查,但结合方法并不常见.
- 儿科烧伤患者的大量上部胃肠道出血是一种罕见但关键的并发症.
研究的目的:
- 报告一例罕见的儿童患者在严重烧伤后出现大规模上部胃肠道出血的病例.
- 评估结合胃镜和血管栓塞的多学科方法的疗效,以治疗儿童的烧伤后胃肠道出血.
- 突出通过导管栓塞作为潜在的更安全和更有效的静血方法,为儿科患者不适合内镜治疗.
主要方法:
- 一名3岁的男孩严重烧伤,出现严重的胃肠道出血,休克和扩散性血管内凝血 (DIC).
- 最初用止血药物治疗是无效的. 一个多学科团队 (MDT) 引导诊断胃镜,确定出血的十二指肠.
- 由于儿科患者内镜控制的局限性,因此进行了胃腹动脉的透管动脉栓塞.
主要成果:
- 胃镜成功地确定了出血源,但由于患者的解剖学,内镜血静不能实现.
- 胃关节动脉栓塞在技术上成功控制了活跃的胃肠道出血.
- 患者在术后没有出现胃肠道出血的进一步迹象,并在6个月的随访期间保持良好状态.
结论:
- 这一案例证明了多学科方法的成功应用,将胃镜和干预栓塞整合起来,用于治疗儿科烧伤患者急性大规模上部胃肠道出血.
- 过导管栓塞是一种可行的和有效的替代方案,用于在内镜检查不足时,在患有严重的烧伤后胃肠道出血的儿科患者中实现血液静止.
- 联合策略突出了治疗严重烧伤儿童危及生命的胃肠道并发症的关键临床参考.
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