一名因子宫出血就诊的患者，继发于严重贫血的进行性充血性心力衰竭病例。

A case of progressive congestive heart failure secondary to severe anemia in a patient presenting with uterine hemorrhage.

作者信息

Yamashita S, Matsumiya N, Fujii T, Yamaguchi H

机构信息

Department of Anesthesia, Tsuchiura Kyodo Hospital, Ibaraki, Japan.

出版信息

Resuscitation. 1999 Sep;42(1):69-72. doi: 10.1016/s0300-9572(99)00085-4.

DOI:10.1016/s0300-9572(99)00085-4

PMID:10524733

Abstract

In this report, we present a 42-year-old female patient who was transferred to our emergency department due to symptoms of congestive heart failure. She presented with severe anemia (hemoglobin was 1.3 g dl(-1), and hematocrit was 6.0%) due to continuous uterine hemorrhage and metabolic acidosis, otherwise she seemed to be free from illness. We diagnosed that she was suffered from chronic severe anemia due to uterine hemorrhage and congestive heart failure. Monitoring her hemodynamic status, treatment of congestive heart failure using diuretics and inotropes in combination with blood transfusion brought her good recovery. We discussed this case from the mechanisms of development of congestive heart failure in a chronic severe anemic condition, and pointed out that distributive effects of sodium and water may develop congestive heart failure without myocardial dysfunction in such a condition.

摘要

在本报告中，我们介绍了一名42岁的女性患者，她因充血性心力衰竭症状被转诊至我院急诊科。她因持续性子宫出血和代谢性酸中毒而出现严重贫血（血红蛋白为1.3 g dl⁻¹，血细胞比容为6.0%），除此之外她似乎并无其他疾病。我们诊断她患有因子宫出血和充血性心力衰竭导致的慢性严重贫血。监测她的血流动力学状态，使用利尿剂和正性肌力药物治疗充血性心力衰竭并结合输血使她恢复良好。我们从慢性严重贫血状态下充血性心力衰竭的发生机制方面讨论了该病例，并指出在这种情况下，钠和水的分布效应可能在无心肌功能障碍的情况下引发充血性心力衰竭。