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再生障碍性贫血合并非闭塞性肠系膜缺血

Aplastic Anemia With Non-Occlusive Mesenteric Ischemia.

作者信息

Rai Rithvik, Kehinde Abiola

机构信息

Geriatrics and Endocrinology, Hinchingbrooke Hospital, Huntingdon, GBR.

Endocrinology and Diabetes, Hinchingbrooke Hospital, Huntingdon, GBR.

出版信息

Cureus. 2024 Oct 30;16(10):e72727. doi: 10.7759/cureus.72727. eCollection 2024 Oct.

DOI:10.7759/cureus.72727
PMID:39478766
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524600/
Abstract

This case highlights the multifaceted challenges of managing aplastic anemia, especially when complicated by non-occlusive mesenteric ischemia (NOMI). The patient's clinical course underscores the importance of a conservative, multidisciplinary approach in balancing the risks of invasive procedures with the need for effective diagnostics and treatment. Recognizing the risks associated with pancytopenia, including life-threatening bleeding and infections, is critical in managing such patients. Careful monitoring and timely interventions, particularly in an intensive care setting, are essential to improve outcomes in complex cases like this one.

摘要

本病例凸显了再生障碍性贫血管理所面临的多方面挑战，尤其是在合并非闭塞性肠系膜缺血（NOMI）时。患者的临床病程强调了在平衡侵入性操作风险与有效诊断及治疗需求时采用保守的多学科方法的重要性。认识到全血细胞减少相关的风险，包括危及生命的出血和感染，对于管理此类患者至关重要。仔细监测和及时干预，特别是在重症监护环境中，对于改善像这样的复杂病例的预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c66/11524600/0eae3c1a605a/cureus-0016-00000072727-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c66/11524600/0eae3c1a605a/cureus-0016-00000072727-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c66/11524600/0eae3c1a605a/cureus-0016-00000072727-i01.jpg

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本文引用的文献

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The virtual uncertainty of futility in emergency surgery.急诊手术中无效的虚拟不确定性。
Br J Surg. 2022 Nov 22;109(12):1184-1185. doi: 10.1093/bjs/znac313.
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Acute Gut Ischemia.急性肠道缺血。
Surg Clin North Am. 2018 Oct;98(5):995-1004. doi: 10.1016/j.suc.2018.06.002. Epub 2018 Jul 29.
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The Child With Macrocephaly: Differential Diagnosis and Neuroimaging Findings.头围过大的儿童：鉴别诊断与神经影像学表现。
AJR Am J Roentgenol. 2018 Apr;210(4):848-859. doi: 10.2214/AJR.17.18693. Epub 2018 Feb 22.
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Palliative Care in Surgery: Defining the Research Priorities.外科姑息治疗：确定研究重点。
J Palliat Med. 2017 Jul;20(7):702-709. doi: 10.1089/jpm.2017.0079. Epub 2017 Mar 24.
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Safety of endoscopic interventions in patients with thrombocytopenia.血小板减少症患者内镜干预的安全性。
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Effects of a multimodal management strategy for acute mesenteric ischemia on survival and intestinal failure.多模式管理策略对急性肠系膜缺血患者生存和肠衰竭的影响。
Clin Gastroenterol Hepatol. 2013 Feb;11(2):158-65.e2. doi: 10.1016/j.cgh.2012.10.027. Epub 2012 Oct 25.
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Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis.多排 CT 在急性肠系膜缺血中的诊断准确性：系统评价和荟萃分析。
Radiology. 2010 Jul;256(1):93-101. doi: 10.1148/radiol.10091938.
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CT diagnosis of acute mesenteric ischemia from various causes.各种原因所致急性肠系膜缺血的CT诊断
AJR Am J Roentgenol. 2009 Feb;192(2):408-16. doi: 10.2214/AJR.08.1138.