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在急性胰腺炎中肺栓塞的持续风险,尽管预防性抗凝治疗
Talal Alomar1, Anupama Somaratna1, Deepti Boddupalli1
1Internal Medicine, Creighton University School of Medicine, Phoenix, USA.
Cureus
|December 24, 2024
概括
急性胰腺炎可以导致危险的血栓,如肺栓塞 (PE),即使有预防性抗凝血. 这一案例凸显了在严重炎症状态下提高警和可能调整抗凝剂的必要性.
科学领域:
- 内部医学 内部医学
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
背景情况:
- 急性胰腺炎诱导高凝血状态,增加深静脉血栓症 (DVT) 和肺栓塞 (PE) 的风险.
- 标准的预防性抗凝药可能在患有严重炎症状况 (如胰腺炎) 的患者中不足.
研究的目的:
- 报告一种独特的严重肺栓塞 (PE) 病例,该病例发生在患有急性胰腺炎的患者身上,尽管他接受了预防性抗凝药.
- 强调在急性胰腺炎和严重炎症患者中考虑PE的重要性.
主要方法:
- 一份病例报告详细介绍了一名27岁的男性,被诊断患有急性胰腺炎和糖尿病酸症 (DKA).
- 患者接受了预防性埃诺沙巴林,但后来发生了急性呼吸失补偿.
- 双边PEs的诊断,包括栓,通过CT血管造影得到证实,随后是出现的血栓切除术.
主要成果:
- 一名患有急性胰腺炎的患者发生了大规模的肺栓塞 (PE),尽管服用了预防性埃诺沙巴林.
- 紧急血栓切除术成功地解决了患者的症状.
- 患者转换为治疗性抗凝药,并在两个月后在没有复发的情况下在阿皮克萨班上出院.
结论:
- 患有急性胰腺炎和严重炎症的患者可能需要更积极的抗凝策略.
- 对于PE的警在炎症条件中至关重要,即使使用标准预防措施.
- 目前的指导方针可能需要修订,以解决胰腺炎引起的高凝血状态中的抗凝血.
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