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一名患有特纳综合征的儿科患者主动脉夹层的诊断与管理:一项模拟研究

Diagnosis and Management of Aortic Dissection in a Pediatric Patient With Turner Syndrome: A Simulation.

作者信息

Attridge Megan M, Hopkins Kali A, Mangold Karen, Brickman Wendy J, Patel Sheetal R

机构信息

Pediatric Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.

Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, USA.

出版信息

Cureus. 2023 Jul 11;15(7):e41725. doi: 10.7759/cureus.41725. eCollection 2023 Jul.

Abstract

Aortic dissection is exceedingly rare in the pediatric population. However, it is much more common among children and adolescents with certain underlying syndromes, including Turner syndrome. Furthermore, aortic dissection carries significant mortality without prompt diagnosis and management. Therefore, pediatric emergency providers should know how to recognize and treat pediatric aortic dissection in a patient with Turner syndrome. We designed this simulation for pediatric emergency medicine fellows. A simulated adolescent female patient with a known history of Turner syndrome presents with chest pain, tachycardia, and hypertension. Participants must order and interpret the appropriate diagnostics, diagnose aortic dissection, and manage aortic dissection adequately. This simulation was completed by six pediatric emergency medicine fellows and one pediatric resident. After completing the simulation, six participants (85.7%) provided anonymous feedback on a five-point Likert scale (one = strongly disagree, five = strongly agree). Feedback was positive, and participants agreed that the case content was relevant to their clinical practice and that the event will improve their clinical practice. This simulation encourages participants to recognize and manage pediatric aortic dissection in patients with Turner syndrome. Participants felt that the simulation was relevant and will improve their clinical practice.

摘要

主动脉夹层在儿科人群中极为罕见。然而,在患有某些潜在综合征(包括特纳综合征)的儿童和青少年中更为常见。此外,主动脉夹层若不及时诊断和处理,会导致显著的死亡率。因此,儿科急诊医护人员应了解如何识别和治疗患有特纳综合征患者的儿科主动脉夹层。我们为儿科急诊医学住院医师设计了这个模拟病例。一名已知有特纳综合征病史的模拟青春期女性患者出现胸痛、心动过速和高血压。参与者必须开出并解读适当的诊断检查、诊断主动脉夹层,并对主动脉夹层进行充分处理。这个模拟病例由六名儿科急诊医学住院医师和一名儿科住院医生完成。完成模拟后,六名参与者(85.7%)以五点李克特量表(1 = 强烈不同意,5 = 强烈同意)提供了匿名反馈。反馈是积极的,参与者一致认为病例内容与他们的临床实践相关,并且该模拟将改善他们的临床实践。这个模拟鼓励参与者识别和处理患有特纳综合征患者的儿科主动脉夹层。参与者认为该模拟与实际相关,并将改善他们的临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c78c/10414799/4ee0ab252b8e/cureus-0015-00000041725-i01.jpg

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