结肠系膜血管瘤合并Kasabach-Merritt综合征破裂伴失血性休克1例并文献复习
Journal of Clinical Pediatric Surgery(2019)
Abstract
患儿,男,2月龄,因发现患儿面色苍白、反应差、呼吸急促转入南方医科大学珠江医院,查体:体温:36.7℃,脉搏:153次/min,呼吸:45次/min,血压:68/48 mmHg,全身皮肤苍白,末梢循环差,手足、躯干散见数粒红色皮疹,压之不褪色.腹部膨隆,左中腹部可触及大小约8 cm×6 cm包块,质硬、边界清楚、活动度欠佳,无明显触压痛,移动性浊音阳性.血常规:WBC 3.55×109/L、Hb 53 g/L、HCT 0.16、PLT 11×109/L;凝血功能:PT 20.7 s、APTT 48.8 s、TT28.7 s、Fg 0.32g/L、DDI 18.9 mg/L;CT:中腹部可见大小约8 cm×6 cm×6 cm肿物,考虑来源于肠系膜;腹腔穿刺抽出大量不凝血.术前诊断为:①腹部肿块;②失血性休克;③凝血功能障碍;④重度贫血;⑤多器官功能衰竭.患儿病情危重,予扩容、输血、输血浆、输血小板、抗炎及改善循环等治疗后急诊行剖腹探查术.
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