在移植后的患者中,阿司匹林诱导的严重肠炎
Noriyuki Kurimoto1,2, Shuhei Hosomi3, Rieko Nakata1
1Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Clinical journal of gastroenterology
|September 11, 2025
概括
低剂量阿司匹林可以在移植患者中引起严重的肠炎. 保守的管理,包括停止服用阿司匹林,有效地治疗了这种药物诱导的胃肠道损伤.
科学领域:
- 胃肠病学 胃肠病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 肠膜涂层低剂量阿司匹林通常用于心血管保护.
- 移植接受者是一个独特的患者群体,他们的免疫状况和药物代谢发生了变化.
- 与阿司匹林使用相关的胃肠道并发症可能是严重的,特别是在脆弱人群中.
研究的目的:
- 在移植接受者中报告肠膜涂层低剂量阿司匹林导致的严重肠炎的病例.
- 为了强调在免疫受损的个体中,低剂量阿司匹林可能造成严重的胃肠道损伤.
- 突出早期识别的重要性和药物诱导肠炎的保守管理策略.
主要方法:
- 一个42岁的女性移植接受者的案例介绍.
- 临床评估,包括对局部性腹膜炎的评估.
- 内镜和组织学检查以确定肠炎的病因.
- 包括阿司匹林停用,肠休息和抗生素治疗在内的管理.
主要成果:
- 患者在服用肠膜涂层低剂量阿司匹林时出现了严重的肠炎和局部腹膜炎.
- 内镜和组织学发现证实了药物诱导的肠炎,排除了感染性原因.
- 保守的管理,包括阿司匹林停止,禁食和抗生素,导致在没有手术干预的情况下成功恢复.
结论:
- 低剂量阿司匹林,即使在肠膜涂层配方中,也可以在免疫受损患者中导致严重的胃肠道损伤,如肠炎.
- 接受脏移植的人可能面临阿司匹林诱导肠炎的风险增加.
- 早期诊断和及时的保守管理对于避免药物诱导肠炎的手术并发症至关重要.
相关概念视频
01:26Kidney Transplant II: Surgical Procedure
325
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
325
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
271
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
271
01:16Kidney Transplant III: Nursing Management
321
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
321
01:28Kidney Transplant I: Introduction
349
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
349
01:27Acute Pyelonephritis I: Introduction
508
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
508
01:22Acute Kidney Injury I: Introduction
586
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
586