Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Du...Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Due to the varied initial presentation, treatment may be delayed, leading to poorer outcomes. Here, we present a unique case of a 27-year-old schizophrenic patient who initially presented with acute respiratory failure and septic shock and was ultimately diagnosed with cavitary pneumonia secondary to esophageal perforation.展开更多
@Yun Qian$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 3...@Yun Qian$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Chi-Chun Wong$Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, the Chinese University of Hong Kong!Hong Kong, China@San-Chuan Lai$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Zheng-Hua Lin$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Wei-Liang Zheng$Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Hui Zhao$Emergency Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Kong-Han Pan$Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Shu-Jie Chen$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Jian-Min Si$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province,展开更多
目的探讨间接能量测定法指导个体化营养方案对休克型肺炎患者能量代谢的影响。方法选择2020年1月至2023年1月在连云港市第二人民医院接受治疗的96例休克型肺炎患者,分别采用间接能量测定法(能量代谢监护仪)计算每日静息能量消耗(REE)值...目的探讨间接能量测定法指导个体化营养方案对休克型肺炎患者能量代谢的影响。方法选择2020年1月至2023年1月在连云港市第二人民医院接受治疗的96例休克型肺炎患者,分别采用间接能量测定法(能量代谢监护仪)计算每日静息能量消耗(REE)值,根据随机数字表法分为观察组(48例)与对照组(48例),观察组制定个体化营养方案,对照组采用匀浆膳方案。比较两组患者营养支持治疗前后蛋白质代谢营养指标、上臂肌围、体质量指数、血糖及预后情况。结果观察组治疗2周后总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)水平、上臂肌围、体质量指数[分别为(66.42±12.37)g·L^(-1),(38.44±3.25)g·L^(-1),(28.37±2.89)g·L^(-1),(25.96±2.03)cm,(22.93±1.62)kg·m^(-2)]均高于对照组[分别为(58.57±11.48)g·L^(-1),(34.37±3.89)g·L^(-1),(24.88±3.16)g·L^(-1),(23.87±1.89)cm,(21.64±1.58)kg·m^(-2)](t=3.223,5.563,5.646,5.221,3.950,均P<0.05),而空腹血糖(FPG),餐后2 h血糖(2 h PG)水平[分别为(6.36±1.02)mmol·L^(-1),(8.05±1.64)mmol·L^(-1)]均低于对照组[分别为(7.54±1.09)mmol·L^(-1),(9.87±1.52)mmol·L^(-1)](t=5.476,5.639,均P<0.05)。观察组机械通气时间,ICU住院时间,28 d病死率及发热发生率[分别为(9.09±1.48)d,(15.36±1.78)d,18.75%,8.33%]均低于对照组[分别为(10.37±1.56)d,(17.49±1.67)d,27.08%,22.92%](t=4.124,6.046,χ^(2)=0.944,3.872,均P<0.05)。结论间接能量测定法指导个体化营养方案能有效改善休克型肺炎患者营养状况及预后。展开更多
文摘Esophageal perforation, a rare condition, can arise from iatrogenic, traumatic, or spontaneous origins. Even when therapy is initiated within the first 24 hours, it is associated with a mortality rate of up to 25%. Due to the varied initial presentation, treatment may be delayed, leading to poorer outcomes. Here, we present a unique case of a 27-year-old schizophrenic patient who initially presented with acute respiratory failure and septic shock and was ultimately diagnosed with cavitary pneumonia secondary to esophageal perforation.
基金Supported by the National Natural Science Foundation of China,No.81372623the Zhejiang Province Key Science and Technology Innovation Team,No.2013TD13
文摘@Yun Qian$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Chi-Chun Wong$Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, the Chinese University of Hong Kong!Hong Kong, China@San-Chuan Lai$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Zheng-Hua Lin$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Wei-Liang Zheng$Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Hui Zhao$Emergency Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Kong-Han Pan$Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Shu-Jie Chen$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province, China@Jian-Min Si$Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University!Hangzhou 310016, Zhejiang Province, China$Institute of Gastroenterology, Zhejiang University!Hangzhou 310016, Zhejiang Province,
文摘目的探讨间接能量测定法指导个体化营养方案对休克型肺炎患者能量代谢的影响。方法选择2020年1月至2023年1月在连云港市第二人民医院接受治疗的96例休克型肺炎患者,分别采用间接能量测定法(能量代谢监护仪)计算每日静息能量消耗(REE)值,根据随机数字表法分为观察组(48例)与对照组(48例),观察组制定个体化营养方案,对照组采用匀浆膳方案。比较两组患者营养支持治疗前后蛋白质代谢营养指标、上臂肌围、体质量指数、血糖及预后情况。结果观察组治疗2周后总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)水平、上臂肌围、体质量指数[分别为(66.42±12.37)g·L^(-1),(38.44±3.25)g·L^(-1),(28.37±2.89)g·L^(-1),(25.96±2.03)cm,(22.93±1.62)kg·m^(-2)]均高于对照组[分别为(58.57±11.48)g·L^(-1),(34.37±3.89)g·L^(-1),(24.88±3.16)g·L^(-1),(23.87±1.89)cm,(21.64±1.58)kg·m^(-2)](t=3.223,5.563,5.646,5.221,3.950,均P<0.05),而空腹血糖(FPG),餐后2 h血糖(2 h PG)水平[分别为(6.36±1.02)mmol·L^(-1),(8.05±1.64)mmol·L^(-1)]均低于对照组[分别为(7.54±1.09)mmol·L^(-1),(9.87±1.52)mmol·L^(-1)](t=5.476,5.639,均P<0.05)。观察组机械通气时间,ICU住院时间,28 d病死率及发热发生率[分别为(9.09±1.48)d,(15.36±1.78)d,18.75%,8.33%]均低于对照组[分别为(10.37±1.56)d,(17.49±1.67)d,27.08%,22.92%](t=4.124,6.046,χ^(2)=0.944,3.872,均P<0.05)。结论间接能量测定法指导个体化营养方案能有效改善休克型肺炎患者营养状况及预后。
