Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, MD.
Associate Professor, Assistant Residency Program Director, Director of Clinical Research, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD.
Emerg Med Pract. 2024 Aug 1;26(8):1-24. Print 2024 Aug.
Sickle cell disease is a chronic hematologic disease that affects over 100,000 people in the United States. Many of these patients will present to the emergency department seeking treatment for an acute complication. Vaso-occlusive crisis, the most common recurring complication, can be difficult to manage because of the stigma patients face surrounding management of their pain. Patients with sickle cell disease presenting with conditions such as pain, infection, respiratory distress, stroke, or priapism must be given special consideration, as management can differ from that of the general population. This review evaluates the current guidelines and literature on acute complications related to sickle cell disease to dispel misconceptions about seemingly harmless interventions and provide clarification on those that are more controversial. Novel treatments that may have future impact on the management of patients with sickle cell disease are also reviewed.
镰状细胞病是一种慢性血液病，影响美国超过 10 万人。这些患者中的许多人会到急诊室寻求急性并发症的治疗。血管阻塞危机是最常见的复发性并发症，由于患者在管理疼痛方面面临的耻辱感，因此很难进行管理。镰状细胞病患者出现疼痛、感染、呼吸窘迫、中风或阴茎异常勃起等情况必须给予特别考虑，因为其管理方法可能与普通人群不同。本综述评估了与镰状细胞病相关的急性并发症的现有指南和文献，以消除对看似无害的干预措施的误解，并对更具争议性的干预措施进行澄清。还回顾了可能对镰状细胞病患者管理产生未来影响的新型治疗方法。
