— 生理適應 · HARD · SATA —
一位急性胰臟炎病人有低血鈣的風險。下列哪些徵象顯示有此併發症？（選所有適合的）
A client with acute pancreatitis is at risk for hypocalcemia. Which signs indicate this complication? (Select all that apply.)
- APositive Chvostek's sign✓ 正解Chvostek氏徵象陽性
- BTrousseau's sign✓ 正解Trousseau氏徵象
- CHypoactive deep tendon reflexes深層肌腱反射減退
- DProlonged QT interval✓ 正解QT間期延長
- EMuscle tetany✓ 正解肌肉強直痙攣
— Explanation · 中文詳解 —
急性胰臟炎導致脂肪壞死，脂肪酸與鈣離子結合形成皂化反應，導致低血鈣。低血鈣呈現神經肌肉興奮性增加，包括 Chvostek's 徵象（面神經敲擊）、Trousseau's 徵象（血壓計加壓後手部痙攣）、肌肉抽搐（Tetany）與 QT 間期延長。C 選項錯誤，低血鈣應表現為深部肌腱反射增強（Hyperactive）。
Acute pancreatitis can lead to hypocalcemia due to saponification, where fatty acids bind calcium, resulting in signs of neuromuscular irritability such as positive Chvostek’s and Trousseau’s signs, muscle tetany, and a prolonged QT interval. Hypocalcemia typically causes hyperactive deep tendon reflexes rather than hypoactive ones, making option C incorrect.
✦ 台美臨床差異
台美護理教育均高度重視胰臟炎併發症監測，但在台灣臨床評估中，Trousseau's sign 執行率可能較低。