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紧急阑尾切除术后的手术并发症以及线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）患者手术管理的考量因素

Surgical Complication Following Urgent Appendectomy and Considerations in Surgical Management of a Patient With Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS).

作者信息

Cassimatis Nicholas, Ruzicka Francis, Reilly Kaitlin, Kumar Rajat

机构信息

Neurological Surgery, Hackensack Meridian School of Medicine, Hackensack, USA.

Neurology, Hackensack Meridian School of Medicine, Hackensack, USA.

出版信息

Cureus. 2023 May 17;15(5):e39129. doi: 10.7759/cureus.39129. eCollection 2023 May.

DOI:10.7759/cureus.39129
PMID:37332441
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10273776/
Abstract

This case report details a surgical complication with a delayed presentation in a 23-year-old male with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). MELAS is a rare entity that can complicate the routine medical and surgical management of patients. Without sufficient research and guidelines, decision-making for patients who require time-sensitive care may be difficult. This patient population may require special consideration and preventative measures to maximize safety in their surgical care. This case serves to highlight a surgical complication that MELAS patients may be susceptible to, as well as to detail possible means of prevention and protection.

摘要

本病例报告详细介绍了一名23岁患有线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）的男性患者出现的手术并发症，且该并发症为延迟表现。MELAS是一种罕见病症，可使患者的常规医疗和手术管理变得复杂。由于缺乏充分的研究和指导方针，对于需要及时治疗的患者而言，决策可能会很困难。这类患者群体可能需要特殊考虑和预防措施，以在手术治疗中最大限度地提高安全性。本病例旨在突出MELAS患者可能易患的一种手术并发症，并详细说明可能的预防和保护方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/ef4ee16f81bf/cureus-0015-00000039129-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/8e1cdbabbb30/cureus-0015-00000039129-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/f5eae11ce42d/cureus-0015-00000039129-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/ef4ee16f81bf/cureus-0015-00000039129-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/8e1cdbabbb30/cureus-0015-00000039129-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/f5eae11ce42d/cureus-0015-00000039129-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcce/10273776/ef4ee16f81bf/cureus-0015-00000039129-i03.jpg

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本文引用的文献

1
Adult-Onset Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS) in a Patient Without Significant Family History.无明显家族史患者的成人起病型线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）
Cureus. 2022 Jan 25;14(1):e21597. doi: 10.7759/cureus.21597. eCollection 2022 Jan.
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Recommendations for the Management of Strokelike Episodes in Patients With Mitochondrial Encephalomyopathy, Lactic Acidosis, and Strokelike Episodes.线粒体脑肌病伴高乳酸血症和卒中样发作患者卒中样发作的管理建议。
JAMA Neurol. 2016 May 1;73(5):591-4. doi: 10.1001/jamaneurol.2015.5072.
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线粒体脑肌病伴乳酸血症和卒中样发作综合征：临床表现、发病机制及治疗选择
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Treatment options for mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome.线粒体肌病、脑病、乳酸酸中毒和卒中样发作（MELAS）综合征的治疗选择。
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A neurological perspective on mitochondrial disease.从神经学角度看线粒体疾病。
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Inherited metabolic disorders and stroke part 1: Fabry disease and mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes.遗传性代谢紊乱与中风 第1部分：法布里病和线粒体肌病、脑病、乳酸性酸中毒及类中风发作
Arch Neurol. 2010 Jan;67(1):19-24. doi: 10.1001/archneurol.2009.309.