[由于严重阻塞性睡眠呼吸暂停引起的血]
Mohamed Garhy1, Charlotte Eggers1, Chiraz Chwich1
1Klinik für Innere Medizin, Pneumologie und Intensivmedizin, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum Ostwestfalen Lippe (OWL) der Universität Bielefeld, Bielefeld, Deutschland.
Pneumologie (Stuttgart, Germany)
|September 16, 2024
概括
严重的阻塞性睡眠呼吸暂停 (OSA) 可以导致血栓塞 (咳血) 由于极端负的胸内压力从气道阻塞. 这一案例凸显了OSA作为呼吸道出血的一个未被认可的原因.
科学领域:
- 医学 医学 医学 医学 医学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (obstructive sleep apnea,OSA) 是一种常见的疾病,其特点是睡眠期间经常出现上呼吸道崩.
- 血液溶解通常与支气管炎,结核病或肺癌等疾病有关.
- 在医学文献中,OSA和血液溶解之间的联系尚未得到充分证实.
研究的目的:
- 报告严重阻塞性睡眠呼吸暂停引起的慢性血栓塞病例.
- 要突出胸内负压在OSA诱导的气道出血中的作用.
- 为了强调OSA作为血栓塞的差异诊断.
主要方法:
- 一个患有慢性血栓塞和OSA症状的患者的病例报告.
- 临床评估包括在镇静下进行支气管镜检查,揭示了下喉塌陷和气道出血.
- 透皮CO2监测的多睡眠学,以诊断OSA的严重程度和相关的低通风.
主要成果:
- 患者呈现慢性轻度血栓塞,白天嗜睡,以及吸烟史.
- 支气管镜检查显示,在诱导气道崩和负压时,粘膜层出血.
- 多睡眠学证实了严重的OSA (AHI 76/h) 与低通风 (PCO2 56 mmHg).
结论:
- 严重的OSA可以导致显著的胸内负压,导致气道粘膜出血和血液溶解.
- 在对患有血栓塞的患者的差异诊断中应考虑OSA,特别是那些患有肥胖和吸烟等危险因素的患者.
- 以正气道压力有效治疗OSA,可以解决相关的血栓塞.
更多相关视频
相关概念视频
Sleep Apnea
131
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
131
Other Pulmonary Disorders
807
Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
807
Chronic Obstructive Pulmonary Disease
1.2K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.2K
Acute Respiratory Failure-II
183
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
183
Acute Respiratory Failure-IV
131
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
131
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
187
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
187


