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在大量输血后的腹腔综合症在上胃肠道出血:一个病例报告
Hudson Martins de Brito1, Tiago de Almeida Macruz2, Gisele J Wakim2
1Department of Medicine, Federal University of Ceará, Fortaleza, BRA.
Cureus
|March 9, 2026
概括
大规模输血可以导致腹腔综合征 (ACS),这是一种高腹内压力的危险状况. 早期识别和手术减压对于患者的治疗结果至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 外科胃肠道外科手术
- 创伤外科 手术 创伤外科
背景情况:
- 腹腔综合征 (ACS) 是引起器官功能障碍的腹内压力升高.
- ACS通常是出血的结果,但由于液体过载和毛细血管泄漏,大规模输血后也可能发生.
- 大规模输血协议对于管理严重出血至关重要,但存在风险.
研究的目的:
- 报告一种罕见的ACS病例,该病例是在为上部胃肠道出血进行大规模输血后发生的.
- 强调在大量输血期间急性呼吸系统恶化患者中识别ACS的重要性.
- 突出与大量输血诱导的ACS相关的临床挑战和结果.
主要方法:
- 一个82岁的男性因十二指肠出血而接受大量输血的病例报告.
- 监测ACS的症状,包括气道压力升高和耐火性低氧化.
- 静脉内压测量以确认ACS和随后的紧急减压腹腔切除术.
主要成果:
- 患者在复苏期间发展出严重的ACS,血管内IAP为85mmHg.
- 减压性腹腔切除术立即改善了呼吸系统参数.
- 尽管进行了干预,但患者经历了多器官衰竭,包括ARDS和MRSA肺炎,导致预后不佳.
结论:
- ACS是大量输血的罕见但关键并发症,需要高度临床警.
- 及时识别和手术减压对于管理ACS至关重要.
- 患有急性呼吸衰竭的大规模输血患者需要对ACS进行彻底评估.
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