MDT模式下成功救治胃穿孔合并甲状腺功能亢进危象1例报道  

Successful treatment of gastric perforation combined with hyperthyroidism crisis by MDT mode:a case report

作　　者：王瓯越 黄聪[1] WANG Ouyue;HUANG Cong(Department of General Surgery,Fuling Central Hospital of Chongqing City,Chongqing 408000,P.R.China)

机构地区：[1]重庆市涪陵中心医院普通外科,重庆408000

出　　处：《中国普外基础与临床杂志》2020年第6期734-738,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探究多学科协作团队(MDT)在诊治胃穿孔合并甲状腺功能亢进(甲亢)危象中的作用和意义。方法对重庆市涪陵中心医院于2019年2月收治的1例胃穿孔合并甲亢患者展开MDT讨论治疗的经验进行总结。结果本例患者以急性弥漫性腹膜炎、空腔脏器穿孔为主要诊断入院,既往甲亢病史未予正规治疗。入院后经积极MDT讨论,给予抗感染、控制心率、控制甲亢等一系列治疗并施行胃穿孔修补术。患者围手术期合并甲亢危象。该患者的手术过程顺利,手术时间约110 min,术中出血约50 mL,术中无副损伤发生,未输血,于术后20 d痊愈出院。随访1年期间,患者一般状况及生活均恢复正常。结论胃穿孔合并甲亢危象患者在临床治疗中应采取MDT多学科协助治疗模式,以求提供更佳的治疗方案,取得更好的预后。Objective To investigate the diagnosis and treatment value of multi-disciplinary team(MDT)model in patient with gastric perforation combined with hyperthyroidism crisis.Method We summarized the experiences of MDT model in treating one case of gastric perforation with hyperthyroidism crisis in the Fuling Central Hospital of Chongqing City on February 2019.Results This patient had a history of hyperthyroidism and didn’t receive systemic treatment,diagnosing as acute diffuse peritonitis and perforation of hollow organs.After MDT discussions and a series of treatments,including anti-infection,control of heart rate and hyperthyroidism,this patient underwent surgical treatment of gastric peptic ulcer perforation,during and after the surgery,this patient suffered from hyperthyroid crisis.The surgery was successful,with the operation time was about 110 min,and the blood loss was about 50 mL.There was no side injury occurred without blood transfusion,and the patient was cured and discharged on 20 days after operation.The patient was followed up for about 1 year,and the general condition and life returned to normal.Conclusion MDT discussion is a very helpful way in the treatment of gastric perforation combined with hyperthyroidism crisis and can give a better outcome.

关 键 词：胃穿孔 甲状腺功能亢进危象 急性腹膜炎 手术 多学科协作团队 

分 类 号：R581.1[医药卫生—内分泌] R656.61[医药卫生—内科学]