一个病例报告治疗性血交换在高甘油三血症诱导的胰腺炎
D Behera1, R S Mallhi1, J Philip1
1Department of Immunohematology & Blood Transfusion, Bharati Vidyapeeth Deemed University Medical College, Hospital & Research Centre, Pune, Maharashtra India.
概括
治疗性血交换 (TPE) 迅速降低了严重的高甘油三血症,预防了胰腺炎. 这种拯救生命的治疗维持了稳定的甘油三水平,并且在术后进行了保守的管理.
科学领域:
- 内部医学 内部医学
- 临界护理医学 临界护理医学
- 胃肠病学 胃肠病学
背景情况:
- 过高甘油三血症诱导的胰腺炎 (HTGP) 是一种危急的病症.
- 血清甘油三酸的快速降低对于管理HTGP至关重要.
- 当前的治疗指南可能不能完全反映血交换的疗效.
研究的目的:
- 提出一个案例,证明治疗性血交换 (TPE) 在治疗严重的高甘油三血症诱发性胰腺炎 (HTGP) 的有效性.
- 为了强调TPE的快速降低甘油三的能力.
- 倡导重新评估TPE在HTGP管理中的作用.
主要方法:
- 一个35岁的女性患者的病例报告,她因HTGP而入院.
- 紧急治疗性等离子体交换 (TPE) 使用Spectra Optia Apheresis系统进行.
- 在TPE之前,期间和之后监测血清甘油三水平.
主要成果:
- 在TPE之后,血清甘油三酸盐从3953 mg/dl大幅降低到291 mg/dl.
- 血清甘油三甲酸的降低可以挽救生命.
- 在TPE后的保守治疗中维持了稳定的甘油三水平.
结论:
- 治疗性血交换是一种高效的紧急治疗,用于高甘油三血症引起的胰腺炎.
- TPE提供了快速和拯救生命的血清甘油三降低.
- 对于HTGP治疗,TPE需要在ASFA分类中进行升级.
相关概念视频
Acute Pancreatitis I: Introduction
1.5K
Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
1.5K
Acute Pancreatitis II: Clinical Manifestations and Management
1.2K
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
1.2K
Chronic Pancreatitis I: Introduction
918
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
918
Chronic Pancreatitis II: Collaborative Care
572
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
572
Acute Pancreatitis I: Introduction
26
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
26
Acute Pancreatitis II: Pathophysiology
49
The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
49


