心源性休克患者的舌部缺血性坏死。
Ischemic necrosis of the tongue in patients with cardiogenic shock.
机构信息
Department of Otolaryngology, New York University Medical Center, New York, New York 10016, USA.
出版信息
Laryngoscope. 2010 Jul;120(7):1345-9. doi: 10.1002/lary.20974.
OBJECTIVES/HYPOTHESIS: Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue.
STUDY DESIGN
Retrospective analysis of hospital charts.
METHODS
Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock.
RESULTS
Five critically ill patients in our institution's cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intra-aortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue.
CONCLUSIONS
Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis.
目的/假设：舌缺血性坏死是一种罕见的疾病，通常与血管炎有关。休克的重症患者可能会出现头颈部终末器官（包括舌）灌注不足。
研究设计
医院病历的回顾性分析。
方法
分析了五例因心源性休克而发生舌缺血性坏死的患者的病史和照片。
结果
我院心胸重症监护病房的五名重症患者发生了舌缺血性坏死。所有五名患者均经历了长时间的严重心源性休克，需要大剂量血管加压素支持和紧急心脏手术。三名患者需要主动脉内球囊泵。所有患者均有终末器官灌注不良的表现，包括下肢缺血、肾功能衰竭和肝功能衰竭。最终，五名患者中有四名死亡，一名患者在整个舌部脱落存活。
结论
舌缺血性坏死是休克时终末器官灌注不足的一种罕见但可能报道不足的表现，可能预示预后不良。
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