心肺复苏术的罕见并发症-肝损伤

Q4 Medicine
Medicina Pub Date : 2024-09-09 DOI:10.3390/medicina60091470
David Hoskovec, Pavol Klobušický, Adam Pudlač, Matyáš Lochman, Zdeněk Krška, Petr Dytrych
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引用次数: 0

摘要

背景和目的:肝损伤是心肺复苏术中一种罕见的并发症。正确、早期的诊断和治疗至关重要。损伤的临床症状可能会被心脏骤停所掩盖。我们对心肺复苏后的创伤性肝损伤进行了单中心回顾性观察研究。材料和方法:对因心肺复苏后肝损伤而接受治疗的患者进行回顾性分析。分析了人口统计学数据、复苏原因、自发循环恢复时间(ROSC)和手术方法。结果:我们治疗了九名心肺复苏后严重肝损伤的患者。诊断依据是心肺功能不稳定,8 例患者的红细胞计数下降,并经 CT 或超声波检查确诊。最后一个病例是在核磁共振检查中意外确诊的。对于病情不稳定的患者,在确诊后立即进行手术。我们将肝脏缝合和腹腔内填塞与计划中的二次手术相结合。九名患者中有五人存活了下来。结论心肺复苏术后的肝损伤很少见,但死亡率很高。心肺功能不稳定和/或红细胞计数低或下降是肝损伤的主要征兆。床旁超声波和 CT 扫描是确诊的最重要方法。无论病因如何,手术修复的原则与所有肝损伤相同。存活的关键因素包括早期诊断和恢复自主循环(ROSC)的时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rare Complication of Cardiopulmonary Resuscitation—Liver Injury
Background and Objectives: Liver injury is a rare complication of cardiopulmonary resuscitation. Correct and early diagnosis and treatment are essential. The clinical signs of injury may be masked by the cardiac arrest. We present a single-centre retrospective observational study of traumatic liver injury after cardiopulmonary resuscitation. Materials and Methods: A retrospective analysis of the patients treated for liver injury after cardiopulmonary resuscitation was conducted. Demographic data, the cause of resuscitation, the duration of restoration of spontaneous circulation (ROSC), and the surgical approach were analysed. Results: We have treated nine patients with severe liver injury after cardiopulmonary resuscitation. The diagnosis was made on the basis of cardiopulmonary instability, a fall in the erythrocyte count in eight cases, and was confirmed by CT or ultrasound examination. The last one was diagnosed accidentally on MR. Surgery, in cases of unstable patients, was followed immediately after a diagnosis. We combined liver sutures and intra-abdominal packing with a planned second-look surgery. Five of the nine patients survived. Conclusions: Liver injury after cardiopulmonary resuscitation is rare and is associated with high mortality. The recurrence of cardiopulmonary instability and/or a low or falling red blood cell count are the main signs of this injury. Bedside ultrasound and CT scans are the most important methods to confirm the diagnosis. The rule of surgical repair is the same as in all liver injuries, regardless of aetiology. The key factors for survival include early diagnosis, together with the length of restoration of spontaneous circulation (ROSC).
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来源期刊
Medicina
Medicina Medicine-Medicine (all)
CiteScore
0.10
自引率
0.00%
发文量
66
审稿时长
24 weeks
期刊介绍: Publicada con el apoyo del Ministerio de Ciencia, Tecnología e Innovación Productiva. Medicina no tiene propósitos comerciales. El objeto de su creación ha sido propender al adelanto de la medicina argentina. Los beneficios que pudieran obtenerse serán aplicados exclusivamente a ese fin.
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