最後更新:2026年10月1日
長時間組織受壓引起肌肉壞死、橫紋肌溶解及急性腎衰竭。釋放壓迫後可能發生再灌流傷害。
Feline urethral obstruction (FUO) in male cats is a life-threatening emergency causing hyperkalemia and post-renal azotemia. IV fluid resuscitation, electrocardiographic monitoring, and urethral catheterization are priorities. Saddle thrombus (ATE) requires analgesia (buprenorphine, fentanyl CRI) and anticoagulation.
Canine hemoabdomen requires immediate assessment: packed cell volume trend, FAST scan, and coagulation panel. Splenic hemangiosarcoma is the most common cause of spontaneous hemoperitoneum. Anaphylaxis in dogs presents primarily as GI (hepatic venous congestion) rather than respiratory signs.
這頁有幾個欄位是同系統共用的模板,還沒針對本疾病單獨改寫過。請以臨床判斷為準,記得對照下方文獻。
擠壓傷急救處置(再灌流前後黃金時窗): 1. **釋壓前評估**:意識、循環、評估擠壓區域與時間(>1 hr 即高風險) 2. **建立 IV 通路(釋壓前優先建立)**:14-18 gauge × 2 條(**非擠壓側**);釋壓前先給 isotonic crystalloid 10-20 mL/kg 預擴容,避免再灌流瞬間 hypovolemic shock 3. **抽血基準**:CK / 肌紅蛋白 / 電解質(K+ / Ca+ / P)/ 血氣 / lactate / coagulation 4. **釋壓後處置**: - 持續晶體液 ~150-200 mL/kg/day 目標尿量 1-2 mL/kg/h(沖洗肌紅蛋白) - 鹼化尿液(NaHCO3 1-2 mEq/kg IV)pH > 6.5 預防 myoglobin cast 沉澱於腎小管 - 高血鉀緊急處置:calcium gluconate + insulin/glucose - 監測 compartment syndrome(5P,必要時 fasciotomy) 5. **持續監測 48-72h**:尿量 / CK 趨勢 / 電解質 / ECG / 神經學評估 ⚠️ **禁忌**: - **未建立 IV 即釋壓** — 再灌流瞬間 K+/myoglobin 釋出致命性心律不整 + AKI - **單純利尿(furosemide)** — 不能預防 myoglobin AKI,應靠晶體液 + 鹼化 - **NSAID 用於擠壓傷** — 腎毒性加成 myoglobin AKI 風險
建議:Shock dose crystalloid 20-30 mL/kg IV bolus(犬),10-15 mL/kg(貓),評估反應後調整
速率:20-30 mL/kg
監測頻率:q2-4h
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危及生命的緊急狀態,需在黃金時間內介入 (critical condition requiring golden-hour intervention)
飼主衛教
用藥指引
⚠ 警訊症狀(立即回診)
環境調整
長期計畫:依根本病因制定長期計畫
限制活動
穩定後漸進恢復活動
期間:依病因
及早積極輸液可防止腎衰竭。嚴重案例可能截肢或死亡。
壓砸傷/壓砸症候群 診斷與處置流程
確認壓迫創傷史,解壓前開始輸液
ECG+急查電解質+CK
積極輸液+尿液鹼化+利尿
腎功能追蹤+傷口處理+併發症監測
來源:專家審閱