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急诊科血管性水肿:基于证据的综述。

Angioedema in the emergency department: an evidence-based review.

作者信息

Wilkerson R Gentry

机构信息

Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

Emerg Med Pract. 2012 Nov;14(11):1-21. Epub 2012 Oct 20.

Abstract

Angioedema is the end result of a variety of pathophysiological processes resulting in transient, localized, nonpitting swelling of the subcutaneous layer of the skin or submucosal layer of the respiratory or gastrointestinal tracts. It is now generally accepted that the swelling is mediated by either histamine or bradykinin. Angioedema may result in severe upper airway compromise or-less commonly recognized-compromise in the gastrointestinal tract often associated with severe abdominal pain. A variety of new therapeutic options are becoming available for use in the United States that have the potential to greatly impact the management and outcomes for those with severe clinical manifestations. This review assesses the evidence on the causes and treatments of angioedema in the emergency department and reviews the new therapeutic options available for treatment of angioedema based on their effectiveness, price, and availability.

摘要

血管性水肿是多种病理生理过程的最终结果,导致皮肤皮下层或呼吸道或胃肠道黏膜下层出现短暂、局部、非凹陷性肿胀。目前普遍认为,肿胀是由组胺或缓激肽介导的。血管性水肿可能导致严重的上呼吸道梗阻,或者较少被认识到的胃肠道梗阻,常伴有严重腹痛。在美国,有多种新的治疗选择可供使用,这些选择有可能极大地影响有严重临床表现患者的管理和治疗结果。本综述评估了急诊科血管性水肿病因和治疗的证据,并根据其有效性、价格和可及性,综述了可用于治疗血管性水肿的新治疗选择。

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