拉米切除术后双边上腺出血:一种罕见的并发症
Sapna Sharma1, Michelle Ashley Rizk1, Hafiza Qadeer1
1Department of Endocrinology, Diabetes and Metabolism, Reading Hospital, Reading, PA 19610, USA.
JCEM case reports
|February 6, 2026
概括
双边上腺出血是一种罕见的上腺功能不全的原因,可在创伤和手术后发生. 及时诊断和皮治疗对于患者的康复至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 创伤外科 手术 创伤外科
- 放射学 放射学是一门学科.
背景情况:
- 双侧上腺出血 (BAH) 是一种罕见但危急的疾病.
- 它可以导致危及生命的上腺功能不全.
- 创伤后和手术后的并发症需要仔细考虑.
研究的目的:
- 在L1爆裂骨折的患者中报告BAH病例.
- 突出BAH的诊断挑战和管理.
- 强调在术后患有非特异性症状的患者考虑BAH的重要性.
主要方法:
- 一个63岁的男性患有创伤性L1爆裂骨折的案例介绍.
- 术后监测包括抗凝药.
- 临床评估,实验室评估 (皮质醇,ACTH) 和对上腺质量进行成像 (CT扫描).
- 排除感染原因和氨酸诱导的血小板缺血.
主要成果:
- 患者在术后出现了无法解释的心率下降,肺栓塞和双侧上腺质量.
- 实验室发现表明主要的上腺功能不充分 (无法检测的皮质醇,升高的ACTH).
- 静脉注射的皮治疗导致了快速的临床改善.
结论:
- 在患有血动力学不稳定性和非特异性症状的术后患者中应考虑BAH.
- 早期识别和使用皮质类固醇的治疗对于有利的结果至关重要.
- 这个案例强调了创伤,手术,抗凝血和BAH之间的潜在联系.
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