一个案例报告,来自低水平跌倒的额外心周栓塞
Gillian Judge1, Waslat Bakhshi1, Fiona Sands2
1Emergency Medicine, Mater Misericordiae University Hospital, Dublin, IRL.
Cureus
|December 17, 2024
概括
一名接受阿皮克萨班治疗的61岁男子在摔倒后出现了大型中质血瘤. 使用安德克萨内特α的抗凝药迅速逆转和紧急手术导致完全康复.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 创伤外科 手术 创伤外科
背景情况:
- 从较低的高度落是一个日益严重的公共卫生问题,特别是在老年人中.
- 直接服用口服抗凝剂 (DOAC) 的患者需要仔细考虑创伤中逆转剂.
- 扩张的中动脉瘤是罕见的,特别是来自简单跌倒的前动脉瘤.
研究的目的:
- 为了报告一个罕见的前端中原血瘤扩张的病例.
- 为了突出在创伤中DOAC逆转的管理挑战.
- 强调老年患者早期截面成像的重要性.
主要方法:
- 一个61岁的男性患有胸痛和呼吸短促的病例报告.
- 诊断成像包括CTPA和CT动脉图,确定了中血瘤和肋骨骨折.
- 治疗包括逆转阿皮克萨班与安德克萨内特阿尔法和紧急胸腔切除术.
主要成果:
- 鉴定出一个15厘米的前腹中瘤,导致对右心室产生质量效应.
- 阿皮克萨班成功地与安德克萨尼阿尔法一起逆转.
- 紧急椎切割和血液瘤疏散导致完全康复,没有并发症.
结论:
- 早期的截面成像对于患有跌倒的老年患者至关重要,特别是那些服用抗凝药的人.
- 对DOAC逆转的管理需要多学科的投入和仔细的风险效益评估.
- 这一案例凸显了来自低能耗创伤的前端中血瘤的罕见性和复杂性.
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