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组织型纤溶酶原激活剂给药后引起气道受压的咽后血肿：一例报告

Retropharyngeal Hematoma Causing Airway Compromise After Tissue Plasminogen Activator Administration: A Case Report.

作者信息

Provenza Christian, Habermann Arun Christian, Williams Theron, Metter Jeffrey, Walker James Richard

机构信息

University of Tennessee Health Science Center - Department of Emergency Medicine, Memphis, Tennessee.

University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee.

出版信息

Clin Pract Cases Emerg Med. 2023 Aug;7(3):168-171. doi: 10.5811/cpcem.1602.

DOI:10.5811/cpcem.1602
PMID:37595307
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10438936/
Abstract

INTRODUCTION

Tissue plasminogen activator (tPA), commonly used for treatment of acute ischemic stroke, is associated with life-threatening bleeding intracranially as well as surrounding the airway.

CASE REPORT

A 78-year-old year old male who presented with stroke symptoms and after tPA administration developed a retropharyngeal hematoma requiring intubation and surgical intervention.

CONCLUSION

Numerous threats to the patient's airway can develop after tPA administration. While angioedema is the most common cause, it is important to be prepared for other causes related to hemorrhage.

摘要

引言

组织型纤溶酶原激活剂（tPA）常用于治疗急性缺血性中风，但其与颅内及气道周围危及生命的出血有关。

病例报告

一名78岁男性出现中风症状，在使用tPA后发生咽后血肿，需要插管和手术干预。

结论

使用tPA后可能会出现多种危及患者气道的情况。虽然血管性水肿是最常见的原因，但对其他与出血相关的原因做好准备也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/a66c9fa92e42/cpcem-7-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/55861ed73a28/cpcem-7-168-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/03c1b0eda47a/cpcem-7-168-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/a66c9fa92e42/cpcem-7-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/55861ed73a28/cpcem-7-168-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/03c1b0eda47a/cpcem-7-168-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b553/10438936/a66c9fa92e42/cpcem-7-158-g003.jpg

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本文引用的文献

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Blunt Traumatic Retropharyngeal Hematoma with Respiratory Symptoms: A Systematic Review of Reported Cases.伴有呼吸症状的钝性创伤性咽后血肿：已报道病例的系统评价
Emerg Med Int. 2021 Oct 7;2021:5158403. doi: 10.1155/2021/5158403. eCollection 2021.
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Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.急性缺血性脑卒中患者早期管理指南：2018 年急性缺血性脑卒中早期管理指南的更新：美国心脏协会/美国卒中协会发布的医疗保健专业人员指南。
Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30.
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Airway and circulatory collapse due to retropharyngeal hematoma after blunt vertebral artery injury.钝性椎动脉损伤后因咽后血肿导致气道和循环系统崩溃。
Am J Emerg Med. 2017 May;35(5):806.e5-806.e7. doi: 10.1016/j.ajem.2016.12.006. Epub 2016 Dec 9.
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Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.静脉注射阿替普酶用于急性缺血性脑卒中的纳入和排除标准的科学依据：美国心脏协会/美国卒中协会医疗保健专业人员的声明。
Stroke. 2016 Feb;47(2):581-641. doi: 10.1161/STR.0000000000000086. Epub 2015 Dec 22.
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Surgical Treatment of a Life-Threatening Large Retropharyngeal Hematoma after Minor Trauma : Two Case Reports and a Literature Review.轻微创伤后危及生命的巨大咽后血肿的外科治疗：两例报告及文献综述
J Korean Neurosurg Soc. 2015 Sep;58(3):304-7. doi: 10.3340/jkns.2015.58.3.304. Epub 2015 Sep 30.
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Management of airway compromise following thyroid cyst hemorrhage after thrombolytic therapy.溶栓治疗后甲状腺囊肿出血导致气道受压的处理
Laryngoscope. 2015 Mar;125(3):604-7. doi: 10.1002/lary.24841. Epub 2014 Jul 14.
7
Thyroid hemorrhage causing airway obstruction after intravenous thrombolysis for acute ischemic stroke.静脉溶栓治疗急性缺血性脑卒中后甲状腺出血导致气道阻塞。
Neurocrit Care. 2013 Dec;19(3):381-4. doi: 10.1007/s12028-013-9889-z.
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Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study.急性缺血性卒中的溶栓治疗：加拿大阿替普酶治疗卒中有效性研究的结果
CMAJ. 2005 May 10;172(10):1307-12. doi: 10.1503/cmaj.1041561.
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Neurology. 2003 May 13;60(9):1525-7. doi: 10.1212/01.wnl.0000058840.66596.1a.
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Ann Emerg Med. 2001 Oct;38(4):447-9. doi: 10.1067/mem.2001.116615.