在四肢和性结肠炎的环境中,深静脉血栓的多方面的挑战:病例报告
Priscilla Mapelli1,2, Mitchel Wright3,4, Henry Hrdlicka5
1University of Connecticut School of Medicine, Physical Medicine & Rehabilitation Residency Program, Farmington, CT, USA. mapelli@uchc.edu.
Spinal cord series and cases
|April 1, 2025
概括
患有性结肠炎 (UC) 和脊髓损伤 (SCI) 的患者面临深静脉血栓形成 (DVT) 的风险增加. 在这些患者中管理DVT是复杂的,因为出血风险和UC恶化,使治疗复杂化并导致DVT进展.
科学领域:
- 神经学 神经学
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
背景情况:
- 导致四肢的创伤性脊髓损伤 (SCI) 增加了深静脉血栓塞 (DVT) 风险,这是由于不运动和血液静止的变化.
- 性结肠炎 (UC) 是一种慢性炎症性肠病,增加了血栓事件的风险,以及腹和出血的风险.
- 这一案例凸显了与并发性UC和四肢相关的复合前血栓风险.
研究的目的:
- 在患有性结肠炎 (UC) 和创伤性四肢的患者中报告深静脉血栓形成 (DVT) 的病例.
- 为了说明当抗凝血因出血并发症而禁用时,管理DVT的挑战.
- 讨论SCI,UC恶化和DVT管理之间的相互作用.
主要方法:
- 一个53岁的男性患有UC和创伤性SCI (四肢) 的病例报告.
- 尽管进行了预防,但患者患上了DVT,需要进行干预,包括IVC过器和抗凝药.
- 由于出血并发症,治疗调整是必要的,导致DVT进展和C. difficile感染和UC恶化管理.
主要成果:
- 患者在因出血而停止抗凝血药物后经历了膝盖以上的DVT进展.
- 困难杆菌感染加剧了UC,影响了患者的肠道程序.
- 管理需要同时解决DVT,UC恶化和C. difficile感染.
结论:
- 无论是UC还是创伤性SCI,都会独立增加血栓形成的风险,同时发生时会产生附加效应.
- 结核病恶化和出血并发症在DVT治疗中存在重大挑战,可能导致疾病进展.
- 有效的管理需要仔细考虑出血风险,抗凝策略,并同时管理胃肠道和神经疾病.
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