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新型冠状病毒肺炎患者的大血管血栓形成:病例系列

Large vessel thrombosis in patient with COVID-19, a case series.

作者信息

Baram Aram, Kakamad Fahmi H, Abdullah Hadi M, Mohammed-Saeed Dana H, Hussein Dahat A, Mohammed Shvan H, Abdulrahman Binar B, Mirza Aram J, Abdulla Berwn A, Rahim Hawbash M, Rashid Mohammed J, Mohammed-Al Farhad F, Othman Yad N, Salih Abdulwahid M

机构信息

College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq.

Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq.

出版信息

Ann Med Surg (Lond). 2020 Dec;60:526-530. doi: 10.1016/j.amsu.2020.11.030. Epub 2020 Nov 12.

Abstract

INTRODUCTION

Involvement of the large vessels is rarely reported and poorly understood in cases of Corona virus disease-19 (COVID-19). The aim of this study is to present a series of cases with large vessel thrombosis (LVT).

METHODS

This is a multicenter prospective case series study. The participants were consecutive in order. All the patients were diagnosed as cases of COVID-19 with documented LVT were included in the study. Large vessels were defined as any vessel equal or larger than popliteal artery. The mean duration of follow up was 4 months.

RESULTS

The study included 22 cases, 19 (86.4%) cases were male, 3 (13.6%) patients were females. The age ranged from 23 to 76 with a mean of 48.4 years. Four (18.2%) cases had pulmonary embolism confirmed by IV contrast enhanced chest CT scan. All of the cases showed pulmonary parenchymal ground glass opacities (GGO) and high D-Dimers (ranging from 1267 to 6038 ng/ml with a mean of 3601 ng/ml).

CONCLUSION

COVID-19 is a hidden risk factor of LVT that may endanger the patient's life and lead to major amputation. Despite therapeutic anticoagulants still all COVID-19 patients are at risk for LVT, a high index of suspicion should be created and with minimal symptoms surgical consultation should be obtained.

摘要

引言

在新型冠状病毒肺炎(COVID-19)病例中,大血管受累的报道很少,人们对此了解也很少。本研究的目的是介绍一系列大血管血栓形成(LVT)的病例。

方法

这是一项多中心前瞻性病例系列研究。参与者按顺序连续纳入。所有被诊断为COVID-19且有记录的LVT病例均纳入研究。大血管定义为任何等于或大于腘动脉的血管。平均随访时间为4个月。

结果

该研究纳入22例病例,19例(86.4%)为男性,3例(13.6%)为女性。年龄范围为23至76岁,平均48.4岁。4例(18.2%)经静脉注射造影剂增强胸部CT扫描确诊为肺栓塞。所有病例均显示肺实质磨玻璃影(GGO)和高D-二聚体(范围为1267至6038 ng/ml,平均3601 ng/ml)。

结论

COVID-19是LVT的一个潜在危险因素,可能危及患者生命并导致大截肢。尽管使用了治疗性抗凝剂,但所有COVID-19患者仍有发生LVT的风险,应提高警惕,出现轻微症状时就应寻求外科会诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2c/7695865/10c6c3816e01/gr1.jpg

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