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门诊麻醉过程中发生的暴发性肝衰竭:七氟醚及其他高危因素

Fulminant Hepatic Failure in the Course of an Outpatient Anesthetic Procedure: Sevoflurane among Other High-Risk Factors.

作者信息

Cheron Céline, Hoet Perrine, Renard Nathalie, Vanderweerden Geoffroy, Miscu Cristina, Komuta Mina, Laterre Pierre-François, Hantson Philippe

机构信息

Department of Intensive Care, Université Catholique de Louvain, Cliniques St-Luc, 1200 Brussels, Belgium.

Louvain Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, 1200 Brussels, Belgium.

出版信息

Case Rep Anesthesiol. 2020 Jun 29;2020:5124098. doi: 10.1155/2020/5124098. eCollection 2020.

Abstract

A 20-year-old man underwent an outpatient general anesthetic procedure with sevoflurane for the correction of a bilateral gynecomastia. The patient had been first exposed to sevoflurane two years before, without any complication. He presented an overweight with a body mass index (BMI) of 31.4 kg/m and had an episode of "binge" drinking a few days before anesthesia. He became icteric from postoperative day 9, and after the worsening of liver function tests, the liver biopsy revealed centrilobular necrosis. The patient became encephalopathic and required urgent liver transplantation on postoperative day 30. The possibility of a sevoflurane-related fulminant hepatic failure is discussed.

摘要

一名20岁男性接受了门诊全身麻醉手术,使用七氟醚矫正双侧男性乳房发育症。该患者两年前首次接触七氟醚,未出现任何并发症。他体重超重,体重指数(BMI)为31.4kg/m²,在麻醉前几天有过一次“暴饮”。术后第9天他出现黄疸,肝功能检查结果恶化后,肝脏活检显示小叶中心坏死。患者出现脑病,术后第30天需要紧急进行肝移植。本文讨论了七氟醚相关暴发性肝衰竭的可能性。

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