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在使用tocilizumab时,分支内血管动脉瘤修复因传播性血管内凝血而复杂化
Ella Lubberdink1, Saskia E M Schols2, Teba Alnima3
1Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Journal of vascular surgery cases and innovative techniques
|September 29, 2025
概括
分布式血管内凝血 (DIC) 可能发生在血管内修复后. 一名接受托西利祖马布治疗的患者患有DIC,可能是由于内脏泄漏和药物,在治疗调整后得到缓解.
科学领域:
- 血管外科 血管外科
- 类风湿病学 类风湿病学
- 血液学 血液学 血液学
背景情况:
- 分布式血管内凝血 (DIC) 是内血管程序的一种罕见并发症.
- 巨细胞动脉炎 (GCA) 是一种自身免疫性疾病,通常用免疫抑制剂 (如托西利祖马布) 治疗.
- 胸腔腹腔动脉瘤需要复杂的内血管修复.
研究的目的:
- 在接受tocilizumab治疗的患者内血管动脉瘤修复后报告DIC病例.
- 在这种情况下,调查托西利祖马布在促进DIC中的潜在作用.
主要方法:
- 一个69岁女性的病例报告,患有克劳福德型III型胸腔腹腔动脉瘤.
- 接受了分支内血管动脉瘤修复 (BEVAR).
- 经营的术后DIC,考虑到内脏泄漏和托西利祖马布治疗.
主要成果:
- 患者在BEVAR后发展了DIC.
- DIC被归因于内脏泄漏和托西利祖马布诱导的低纤维素生成血症.
- 停止托西利祖马布治疗和加速第二阶段修复导致DIC解决.
结论:
- 静血失衡,包括DIC,可以发生在内血管程序后.
- 在接受内血管修复的患者中,托西利祖马布可能会促进DIC的进展.
- 仔细考虑患者的药物治疗对于管理术后并发症至关重要.
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