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过敏反应作为创伤情况下休克的罕见原因:一例报告

Anaphylaxis as an Unusual Cause of Shock in the Trauma Setting: A Case Report.

作者信息

López-Vidal Williams Luciano, Enriquez-Montes Maricela Fernanda, Meza-Martinez Daniel A, Gallardo-Cantua Luis M, Hernandez-Guedea Marco A

机构信息

Emergency Shock Trauma Department, Hospital Universitario Dr. José Eleuterio Gonzalez, Monterrey, MEX.

General Surgery, Instituto Mexicano del Seguro Social, Hospital General de Zona No. 33, Monterrey, MEX.

出版信息

Cureus. 2024 Jul 16;16(7):e64696. doi: 10.7759/cureus.64696. eCollection 2024 Jul.

Abstract

Anaphylactic shock is the most severe form of an acute systemic allergic reaction and can be potentially lethal if left untreated. Here, we present the case of a 51-year-old male with no significant medical history, who arrived at our hospital's emergency trauma bay following a motor vehicle accident caused by a sudden onset of malaise while driving. Upon arrival, the patient's airway was patent, but he reported a sensation of a foreign body in his larynx. He also had an oxygen saturation of 88%, although no abnormal breath sounds were auscultated. The patient was also hypotensive and tachycardic, with no favorable response after crystalloid administration. He had no neurological alterations but was diaphoretic, with hives spreading across his trunk and all four extremities. Upon further interrogation, we identified that he had consumed diclofenac, a non-steroidal anti-inflammatory drug (NSAID), 45 minutes before the driving incident. Prompt recognition and management of the anaphylactic shock were initiated alongside the assessment and treatment of the traumatic injuries. This case highlights the importance of considering unusual causes of shock in trauma patients. It underscores the need for a comprehensive approach to patient care in trauma settings, where multiple etiologies of shock should be considered and managed simultaneously.

摘要

过敏性休克是急性全身性过敏反应最严重的形式,若不治疗可能会致命。在此,我们报告一例51岁男性病例,他无重大病史,在驾车时突然不适引发机动车事故后被送至我院急诊创伤科。到达时,患者气道通畅,但他诉说喉部有异物感。尽管未闻及异常呼吸音,但他的血氧饱和度为88%。患者还出现低血压和心动过速,输注晶体液后无良好反应。他无神经功能改变,但多汗,荨麻疹遍布躯干和四肢。进一步询问后,我们发现他在驾车事故发生前45分钟服用了双氯芬酸,一种非甾体抗炎药(NSAID)。在评估和治疗创伤性损伤的同时,迅速对过敏性休克进行了识别和处理。该病例强调了在创伤患者中考虑休克不寻常病因的重要性。它强调了在创伤环境中对患者进行全面护理的必要性,在这种情况下,应同时考虑和处理休克的多种病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/403c/11252533/82017525e8cb/cureus-0016-00000064696-i01.jpg

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