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弥漫性肺泡出血:一种导致大量咯血的罕见且危及生命的病因。

Diffuse Alveolar Hemorrhage: A Rare Life-Threatening Cause of Massive Hemoptysis.

作者信息

Hunt Amy E, Sop Jessica, Kahre Jarrod

机构信息

Emergency Medicine, Charleston Area Medical Center, Charleston, USA.

出版信息

Cureus. 2024 Jul 11;16(7):e64347. doi: 10.7759/cureus.64347. eCollection 2024 Jul.

Abstract

We present a case report of diffuse alveolar hemorrhage (DAH), which presented with massive hemoptysis and impending airway compromise. A previously healthy 33-year-old female presented to the emergency department with dyspnea, chest pain, and massive hemoptysis. Due to impending respiratory failure, the patient was placed on mechanical ventilation and a bronchoscopy revealed a diagnosis of DAH. Throughout the hospital course, the patient received antibiotics, steroids, fresh frozen plasma (FFP), cryoprecipitate, tranexamic acid (TXA), and multiple blood transfusions. The patient was subsequently placed on extracorporeal membrane oxygenation (ECMO), but despite these life-saving measures, the patient died less than 48 hours after her initial presentation. This case serves as a harrowing reminder of DAH's destructive capabilities and the importance of rapid, aggressive management.

摘要

我们报告一例弥漫性肺泡出血(DAH)病例,该病例表现为大量咯血及即将出现的气道受压。一名既往健康的33岁女性因呼吸困难、胸痛和大量咯血就诊于急诊科。由于即将发生呼吸衰竭,患者接受了机械通气,支气管镜检查确诊为DAH。在整个住院过程中,患者接受了抗生素、类固醇、新鲜冰冻血浆(FFP)、冷沉淀、氨甲环酸(TXA)治疗及多次输血。患者随后接受了体外膜肺氧合(ECMO)治疗,但尽管采取了这些挽救生命的措施,患者在首次就诊后不到48小时死亡。该病例惨痛地提醒人们DAH的破坏能力以及快速、积极治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8ca/11316604/affd3428a069/cureus-0016-00000064347-i01.jpg

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