创伤诱导凝血病的管理挑战:需要重新操作的血胸病例报告
Nozomu Motono1, Takaki Mizoguchi1, Masahito Ishikawa1
1Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
The American journal of case reports
|November 30, 2024
概括
创伤诱发性凝血病 (TIC) 涉及复杂的病理生理学,与传播性血管内凝血 (DIC) 截然不同. 有效的管理需要了解ICT.
科学领域:
- 创伤和紧急医疗医学
- 血液学 血液学 血液学
- 手术重症监护手术重症监护
背景情况:
- 创伤诱发性凝血病 (TIC) 是严重创伤引起的严重疾病.
- 它的病理生理学涉及凝血激活,高纤维素分解和消耗凝血病,与传播性血管内凝血 (DIC) 不同.
- 这份病例报告详细介绍了一名患有TIC的患者,其次是多重骨折和血胸.
研究的目的:
- 描述一个患有多重创伤性骨折和血胸的患者的创伤诱导凝血病 (TIC) 的病例.
- 突出ICT的临床表现和管理挑战.
- 强调了解TIC病理生理学对于有效的患者管理的重要性.
主要方法:
- 一个68岁的男性患有,在摔倒后出现了广泛的伤害的病例报告.
- 涉及紧急手术,用血液制品和胺酸复苏,随后由于持续出血而重新手术.
- 静血管理包括电,超声波能量和静血材料.
主要成果:
- 患者经历了严重的血胸,休克和凝血病,尽管最初的治疗.
- 持续性凝血病的证据是低血红蛋白,低血小板数量和长时间的血红蛋白时间-国际正常化比率.
- 需要重新手术来管理持续的从肋骨骨折中流出的出血.
结论:
- 创伤诱导的凝血病 (TIC) 呈现出一种病理生理机制,与分散的血管内凝血 (DIC) 区别开来.
- 严重创伤患者与TIC的管理需要全面了解其独特的病理生理学.
- 这一案例强调了治疗严重创伤性凝血病的复杂性和挑战.
相关概念视频
01:26Flail Chest-II
160
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
160
01:09Coagulation
4.8K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
4.8K
01:05Introduction to Hemostasis
5.7K
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
5.7K
01:26Endoscopic Studies II: Thoracocentesis
204
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
204
01:20Extrinsic and Intrinsic Pathways of Hemostasis
5.6K
Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
5.6K
01:27Pneumothorax-II
120
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
120