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炎症性风湿病急症。

Emergencies in inflammatory rheumatic diseases.

机构信息

Department of Emergency Medicine and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

Department of Epidemiology with the Course of HIV Infection, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

出版信息

Rheumatol Int. 2024 Sep;44(9):1637-1646. doi: 10.1007/s00296-024-05660-y. Epub 2024 Jul 9.

Abstract

Inflammatory rheumatic diseases (IRDs), encompassing a broad spectrum of chronic disorders, typically necessitate prolonged therapeutic intervention. Nevertheless, these diseases can sometimes manifest as severe emergencies requiring prompt and extensive medical intervention. Urgent intervention is essential for effectively recognizing and managing these situations, as they have the potential to be life-threatening and can result in severe morbidity and mortality. Emergencies in IRDs can occur with different frequencies and manifestations, including nervous system issues, severe infections, thrombosis-emboli, renal crises, gastrointestinal issues, and cardiovascular events. The fact that these events can occur across different IRDs underscores the necessity for heightened awareness and readiness among healthcare professionals. The pathophysiologic mechanisms that cause rheumatic emergencies are complex and involve multiple factors. These emergencies frequently arise due to the interplay between the inflammatory characteristics of rheumatic diseases and different systemic triggers. Early detection and treatment can have a substantial impact on an individual's prognosis in cases of severe and life-threatening disorders that require prompt recognition. Rapid decision-making and urgent care are required to effectively address rheumatic emergencies, as well as the implementation of a diagnostic flowchart. This article provides an overview of the emergencies linked to IRDs, classifying and assessing them individually. This article aims to enhance healthcare professionals' knowledge and awareness of critical situations by examining current recommendations and pathophysiological information. Implementing standardized diagnostic and treatment methods, providing patient education, and conducting continuing research into the underlying mechanisms are essential for enhancing the management of these critical situations and improving patient outcomes.

摘要

炎症性风湿病(IRDs)包含广泛的慢性疾病,通常需要长期的治疗干预。然而,这些疾病有时会表现为严重的紧急情况,需要及时和广泛的医疗干预。紧急干预对于有效识别和处理这些情况至关重要,因为它们可能危及生命,并导致严重的发病率和死亡率。IRDs 中的紧急情况可能以不同的频率和表现形式出现,包括神经系统问题、严重感染、血栓栓塞、肾危象、胃肠道问题和心血管事件。这些事件可能发生在不同的 IRDs 中,这突显了医疗保健专业人员提高认识和准备的必要性。引起风湿紧急情况的病理生理机制很复杂,涉及多个因素。这些紧急情况通常是由于风湿性疾病的炎症特征与不同的全身触发因素相互作用引起的。对于需要迅速识别的严重和危及生命的疾病,早期检测和治疗对个体的预后有重大影响。需要快速决策和紧急护理,以有效地处理风湿紧急情况,并实施诊断流程图。本文概述了与 IRDs 相关的紧急情况,对其进行了分类和评估。本文旨在通过检查当前的建议和病理生理信息,提高医疗保健专业人员对危急情况的认识和意识。实施标准化的诊断和治疗方法、提供患者教育以及对潜在机制进行持续研究,对于改善这些危急情况的管理和改善患者预后至关重要。

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