— 生理適應 · MEDIUM · MCQ —
一名急性胰臟炎病人接受靜脈輸液，測量血壓時出現 Trousseau's 徵象。最可能的原因為何種電解質不平衡？
A client with acute pancreatitis is receiving IV fluids. The nurse notes Trousseau's sign during blood pressure measurement. Which electrolyte imbalance is the most likely cause?
- AHyperkalemia高血鉀症
- BHypocalcemia✓ 正解低血鈣症
- CHypomagnesemia低血鎂症
- DHypernatremia高血鈉症
— Explanation · 中文詳解 —
Trousseau's 徵象是低血鈣的特徵性表現（神經肌肉過度興奮）。在急性胰臟炎中，因脂肪壞死導致鈣離子與脂肪酸結合（皂化作用），造成血鈣下降。低血鈣可能誘發手足抽搐，臨床上需觀察 Chvostek's 與 Trousseau's 徵象以早期診斷低血鈣危象。
Trousseau's sign is a characteristic finding of hypocalcemia (neuromuscular hyperexcitability). In acute pancreatitis, fat necrosis binds calcium with fatty acids (saponification), causing serum calcium to fall. Hypocalcemia may trigger tetany; clinically, Chvostek's and Trousseau's signs are observed to detect impending hypocalcemic crisis early.
✦ 台美臨床差異
美台臨床皆視此為嚴重併發症，台灣護理師執行護理紀錄時，常需特別註記評估結果以利醫師調整補鈣計畫。