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气道、呼吸、循环与登革热:一例因严重创伤和重症登革热感染导致的多因素休克病例。

Airway breathing circulation dengue: a case of multifactorial shock due to major trauma and severe dengue infection.

作者信息

Hoang Bui Hai, Tang Thomas Vu, Phan Nguyen Dai Nghia, Nguyen Anh Dung, Dinh Michael Minh Quoc

机构信息

Emergency and Critical Care, Hanoi Medical University Hospital, Hanoi, Vietnam.

Hanoi Medical University, Hanoi, Vietnam.

出版信息

Int J Emerg Med. 2024 Jul 16;17(1):90. doi: 10.1186/s12245-024-00673-7.

DOI:10.1186/s12245-024-00673-7
PMID:39014326
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11251368/
Abstract

BACKGROUND

Dengue is the most common arboviral illness reported globally, endemic to most tropical and sub-tropical regions of the world. Dengue Shock Syndrome is a rare complication of severe Dengue infection resulting in haemorrhagic complications and refractory hypotension. We report on a case of severe dengue diagnosed in a patient with major trauma and illustrate some of the potential challenges and considerations in the clinical management of such cases.

CASE PRESENTATION

A 49-year-old female presented following a road trauma incident with multiple abdominal injuries requiring urgent laparotomy. Her recovery in Intensive Care Unit was complicated by the development of Dengue Shock Syndrome characterised by a falling haemoglobin and platelet count, multiorgan dysfunction and prolonged hospital stay.

CONCLUSIONS

Dengue Shock Syndrome may complicate fluid management and bleeding control in major trauma cases. Awareness of Dengue, particularly in endemic areas and returned travellers may help facilitate early diagnosis and management of complications.

摘要

背景

登革热是全球报告的最常见虫媒病毒病,在世界大多数热带和亚热带地区流行。登革热休克综合征是严重登革热感染的一种罕见并发症,可导致出血并发症和难治性低血压。我们报告一例在严重创伤患者中诊断出的严重登革热病例,并阐述此类病例临床管理中的一些潜在挑战和注意事项。

病例介绍

一名49岁女性在道路创伤事件后出现多处腹部损伤,需要紧急剖腹手术。她在重症监护病房的恢复因登革热休克综合征的发生而复杂化,其特征为血红蛋白和血小板计数下降、多器官功能障碍以及住院时间延长。

结论

登革热休克综合征可能使严重创伤病例的液体管理和出血控制复杂化。对登革热的认识,特别是在流行地区和归国旅行者中,可能有助于促进并发症的早期诊断和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2ad/11251368/81895a79bd8a/12245_2024_673_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2ad/11251368/81895a79bd8a/12245_2024_673_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2ad/11251368/81895a79bd8a/12245_2024_673_Fig1_HTML.jpg

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本文引用的文献

1
Dengue overview: An updated systemic review.登革热概述:更新的系统综述。
J Infect Public Health. 2023 Oct;16(10):1625-1642. doi: 10.1016/j.jiph.2023.08.001. Epub 2023 Aug 3.
2
Multifactorial Shock: A Neglected Situation in Polytrauma Patients.多因素休克:多发伤患者中被忽视的情况。
J Clin Med. 2022 Nov 18;11(22):6829. doi: 10.3390/jcm11226829.
3
Risk factors for mortality in patients with dengue: A systematic review and meta-analysis.登革热患者死亡的风险因素:系统评价和荟萃分析。
Trop Med Int Health. 2022 Aug;27(8):656-668. doi: 10.1111/tmi.13797. Epub 2022 Jul 11.
4
Microvascular dysfunction in septic and dengue shock: Pathophysiology and implications for clinical management.脓毒症和登革热休克中的微血管功能障碍:病理生理学及其对临床管理的意义。
Glob Cardiol Sci Pract. 2020 Nov 30;2020(2):e202029. doi: 10.21542/gcsp.2020.29.
5
Nonoperative management of blunt hepatic injury: an Eastern Association for the Surgery of Trauma practice management guideline.钝性肝损伤的非手术治疗:东部创伤外科学会实践管理指南。
J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S288-93. doi: 10.1097/TA.0b013e318270160d.