关节镜术后并发急性大面积肺栓伴心脏骤停救治探讨

张 先启, 余 祖田, 林 四龙, 潘 宏, 许 桂水
安徽医科大学附属安庆第一人民医院

摘要


在临床诊疗过程中,由于诊治技术落后及临床医生(尤其外科医生)对肺栓塞认识不足,特别是在急性肺栓塞的情况下,
PTE 容易被误诊或遗漏,这常常被缺乏临床经验的年轻医生忽视,曾经被视为罕见的疾病。然而,近些年来,大量的循证医学
证据显示肺血栓栓塞症在我国已经变得普遍。肺血栓栓塞症的主要症状包括高发病率、频繁复发、导致残障、高死亡率以及巨
额的财务压力,这些都使其变得极其危险,并且是对公共卫生构成严重威胁的常见的临床急症。目前,它已经在医疗机构中排
名最后。女性围手术期出现急性大面积肺栓塞伴心脏骤停病例,期间并发高热、颅脑出血、多器官功能衰竭、DIC 及重度贫血
等经过治疗逐渐恢复,未留下后遗症救治心得简要叙述。

关键词


关节镜 ;急性大面积肺栓塞 ;心脏骤停

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参考


[1]MUNOZ T,RONNI A,ALVAREZ P,et al.

Submassive pulmonary throm-boembolism in a patient with

thrombocytopenia: therapeutic challenge[J].Case Rep Crit

Care,2019,2019: 1919401.

[2]SIKORA-SKRABAKA M,SKRABAKA D,

RUGGERI P,et al.D-dimervalue in the diagnosis of

pulmonary embolism-may it exclude only? [J]. J Thorac

Dis,2019,11(3) : 664-672.

[3] 李新妙 . 肺栓塞流行病学及危险因素分析 [D].

长春 : 吉林大学 , 2016.

[4] 丁洁 , 郭晓纲 . 肺栓塞危险因素与预后评价的

研究进展 [J]. 中华危重症医学杂志 ( 电子版 ), 2016,9(1):

58-66.

[5]ENDE-VERHAAR Y M,MEIJBOOM L J,

KROFT L J M,et al. Use- fulness of standard computed

tomography pulmonary angiography per- formed for

acute pulmonary embolism for identification of chronic

thromboembolic pulmonary hypertension:results of the

InShape Ⅲ study[J].J Heart Lung Transplant,2019,3(19)

: 1053-2498.

[6]SECEMSKY E,CHANG Y,JAIN C C,et al

. Contemporary manage-ment and outcomes of patients

with massive and submassive pulmona- ry embolism[J].Am

J Med,2018,131(12) :1506-1514.

[7]KUANG S Y,YANG Y H. A brief introduction

to the overall frame- work of the guidelines for the

diagnosis,treatment and prevention of pulmonary

thromboembolism[J].Chin J Med,2018,53(10) :1070-1071

[8]Baber U, Mastoris I, Mehran R. Balancing ischaemia

and bleeding risks with novel oral anticoagulants[J]. Nat Rev

Cardiol, 2014, 11(12): 693-703.

[9]Sharma M, Corneliu VR, Patel JP, et al. Efficacy and

harms of direct oral anticoagulants in the elderly for stroke

prevention in atrial fibrillation and secondary prevention of

venous thromboembolism CLINICAL PERSPECTIVE:

systematic review and meta-analysis[J]. Circulation,2015,

132(3): 194-204.

[10]Pulmonary Embolism and Pulmonary Vascular

Disease Group,Respir- atory Medicine Branch,Chinese

Medical Association,et al. Guide-lines for diagnosis,

treatment and prevention of pulmonary thromboembolism[J].Natl Med J China,2018,98(14):1060-1087.

[11]STEVENS H,TRAN H. Update on diagnosis

and anticoagulant therapy for venous thromboembolism[J].

Intern Med J,2018,48(10):1175- 1184.

[12] 中华医学会骨科学分会.中国骨科大手术静

脉血栓栓塞症预防指南 [J].中华骨科杂志,2016,36(2):

65-71.

[13]KONSTANTINIDES S V,MEYER G,

BECATTINI C,et al. 2019 ESC Guidelines for the

diagnosis and management of acute pulmonary em- bolism

developed in collaboration with the European Respiratory

So- ciety ( ERS) : The Task Force for the diagnosis

and management of a- cute pulmonary embolism of the

European Society of Cardiology ( ESC) [J].Eur Heart J,

2019,54(2):1-61.

[14]ZHANG Y X,ZHAI Z G.Interpretation

and thinking of the 2018 new edition of the guidelines

for diagnosis,treatment and prevention of pulmonary

thromboembolism-guiding clinical practice with evidence-based medicine guidelines[J].Chin New Clin Med

2019,12 (1):10-12.


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