— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人處於禁食狀態並接受靜脈輸液，哪項評估發現提示有需要立即介入的併發症？
A client with acute pancreatitis is NPO and receiving IV fluids. Which assessment finding indicates a potential complication requiring immediate intervention?
- AReports of 6/10 intensity abdominal pain主訴腹痛強度為 6/10
- BAbsent bowel sounds腸鳴音消失
- CBlood glucose level of 145 mg/dL血糖值 145 mg/dL
- DSerum calcium level of 7.2 mg/dL✓ 正解血清鈣濃度 7.2 mg/dL
— Explanation · 中文詳解 —
低血鈣（< 8.5 mg/dL）是重症急性胰臟炎的嚴重預後指標，常伴隨手足抽搐、Trousseau徵象或Chvostek徵象。胰臟壞死導致脂肪皂化作用消耗鈣離子。其他選項中，腸鳴音消失及腹痛為胰臟炎常見症狀，高血糖通常為暫時性，低血鈣則直接威脅心律與神經系統穩定。
Hypocalcemia is a serious complication of acute pancreatitis caused by fat saponification consuming calcium ions, which poses a high risk for cardiac arrhythmias and neuromuscular instability. While abdominal pain, absent bowel sounds, and hyperglycemia are common findings, low serum calcium requires immediate intervention due to its potential lethality.
✦ 台美臨床差異
台灣醫院多會固定監測離子鈣；美國臨床會更強調監測 Chvostek 及 Trousseau 徵象作為早期神經肌肉興奮性指標。