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物理治疗缓解合并症急性胰腺炎的胸部并发症:一名年轻女性的罕见病例

Physiotherapy to Alleviate Chest Complications in Acute Pancreatitis With Comorbidities: A Rare Case of Young Female.

作者信息

Agrawal Chitwan S, Yadav Vaishnavi, Nikhade Dhanshri

机构信息

Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jun 9;16(6):e62000. doi: 10.7759/cureus.62000. eCollection 2024 Jun.

Abstract

An abnormal buildup of pleural fluid, known as a pleural effusion, results from an imbalance between excessive formation and absorption. Despite the wide range of pleural effusion causes, including pneumonia, congestive heart failure, and cancer, the majority of cases are attributed to pleural fluid buildup. Acute pancreatitis also leads to complications such as systemic inflammatory response syndrome. A complex pathophysiologic reaction to a range of wounds, including trauma and infections, burns, and pancreatitis, is known as systemic inflammatory response syndrome. It was recognized that a variety of injuries exhibited a similar inflammatory response, making them prime candidates for new anti-inflammatory molecules designed to stop the spread of inflammation or provide targeted therapy. Localized inflammation, a protective response that the body regulates at the site of the injury, can, if lost or overly activated, result in a heightened systemic response known as systemic inflammatory response syndrome. The patient is a 19-year-old female who arrived at Acharya Vinoba Bhave Rural Hospital with complaints of abdominal pain for eight days, abdominal distension for three to four days, breathing difficulty for three to four days, and fever. According to the patient's condition, she was unable to perform normal activities of daily living for eight days. She had breathlessness for eight days, which worsened four days ago. She was diagnosed with pleural effusion, acute pancreatitis, and systemic inflammatory response syndrome. This case is unique as the patient is very young and she has multiple health issues such as severe pancreatitis, ischemic heart disease, systemic inflammatory response syndrome, pulmonary consolidation, and pleural effusion at the same time which makes this condition critical. This study aimed to identify the improvement in this patient after getting physiotherapy treatment. Physiotherapy treatment included lifestyle modifications to reduce weight, performing exercise on a daily basis, breathing exercises airway clearance technique, volumetric incentive spirometer segmental expansion, inspiratory muscle training, chest mobilization, chest proprioceptive neuromuscular facilitation (PNF), and graded mobilization to improve patient condition. When added to standard care, a physiotherapy program improves radiological results, spirometric parameters, and hospital stays in pleural effusion patients.

摘要

胸腔积液是指胸腔内液体异常积聚,是由于液体生成过多与吸收之间的失衡所致。尽管胸腔积液的病因多种多样,包括肺炎、充血性心力衰竭和癌症,但大多数病例都归因于胸腔积液的形成。急性胰腺炎还会导致全身炎症反应综合征等并发症。全身炎症反应综合征是对一系列创伤(包括外伤和感染、烧伤以及胰腺炎)的复杂病理生理反应。人们认识到,多种损伤都表现出类似的炎症反应,这使它们成为旨在阻止炎症扩散或提供靶向治疗的新型抗炎分子的主要候选对象。局部炎症是身体在损伤部位进行调节的一种保护反应,但如果丧失或过度激活,可能会导致一种称为全身炎症反应综合征的全身性反应增强。该患者为一名19岁女性,因腹痛8天、腹胀3至4天、呼吸困难3至4天以及发热前来阿查里亚·维诺巴·巴韦农村医院就诊。根据患者病情,她8天无法进行正常的日常生活活动。她已经气短8天,4天前症状加重。她被诊断为胸腔积液、急性胰腺炎和全身炎症反应综合征。该病例较为特殊,因为患者非常年轻,同时患有多种健康问题,如严重胰腺炎、缺血性心脏病、全身炎症反应综合征、肺实变和胸腔积液,这使得病情危急。本研究旨在确定该患者接受物理治疗后的改善情况。物理治疗包括改变生活方式以减轻体重、每天进行锻炼、呼吸练习气道清理技术、容量激励肺活量计节段扩张、吸气肌训练、胸部松动术、胸部本体感觉神经肌肉促进法(PNF)以及分级活动以改善患者状况。在标准护理基础上增加物理治疗方案,可改善胸腔积液患者的影像学结果、肺功能参数并缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4a9/11232477/d0e7e2534169/cureus-0016-00000062000-i01.jpg

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