Chiafery M C, Stephany R A, Holliday K J
Crit Care Nurse. 1993 Jun;13(3):71-6.
The patient in septic shock who develops vascular insufficiency secondary to purpura fulminans is a challenge to the healthcare team. Initial management is directed toward reversing the disease process by administering antibiotics immediately and initiating life-support measures. Emergency measures include optimizing oxygenation and ventilation, reestablishing and/or maintaining circulation and end-organ perfusion and correcting electrolyte imbalances and coagulopathies. After the emergent life-saving needs of the patient have been addressed, attention may be directed toward saving extremities. Epidural sympathetic blockade proved to be successful as an essential adjunctive intervention in preserving the lower extremities of our patient. We encourage other healthcare providers to consider this treatment to help decrease the morbidity of vascular insufficiency secondary to meningococcal purpura fulminans.
因暴发性紫癜继发血管功能不全的感染性休克患者对医疗团队来说是一项挑战。初始治疗旨在通过立即使用抗生素并启动生命支持措施来逆转疾病进程。紧急措施包括优化氧合和通气、重建和/或维持循环及终末器官灌注，以及纠正电解质紊乱和凝血病。在满足患者紧急的救命需求后，注意力可转向挽救肢体。硬膜外交感神经阻滞被证明是成功的，作为一项重要的辅助干预措施，保住了我们患者的下肢。我们鼓励其他医疗服务提供者考虑这种治疗方法，以帮助降低脑膜炎球菌性暴发性紫癜继发血管功能不全的发病率。
