Acute Pulmonary Embolism Following Laparoscopic Ovariectomy: A Case Report

腹腔鏡手術一般被認為比起傳統外科手術具有較低的侵襲性，由於對於病人所產生的手術壓力較低以及病人可以早期活動，腹腔鏡手術在術後發生併發症的機率也相對較少。本文描述一位四十七歲女性，被診斷患有卵巢畸胎瘤，在外院接受完婦科腹腔鏡卵巢切除術數小時後，發生呼吸急促、意識不清與循環休克之現象。在經急救後穩定住病情，隨即轉往本院急診，藉著床邊心電圖以及心臟超音波，高度懷疑急性肺栓塞之可能性並立即轉入加護病房穩定住其病情。雖然臨床上腹腔鏡手術後發生急性肺栓塞的機率並不高，但是對於此高致命性的併發症必須仰賴早期正確的診斷與積極的治療才能改善病人的預後。目前能夠評估婦科腹腔內視鏡術後發生急性肺栓塞的危險因子仍然沒有定論。因此對於術前的預防措施，都是根據病人個別的危險因子以及其他合併的臨床病情來考慮施予。

關鍵字

併發症；腹腔內視鏡手術；肺栓塞

並列摘要

Laparoscopic surgery is usually considered to be less invasive when compared to traditional laparotomy, and is regarded as a relatively low-risk procedure for postoperative complications because of the reduced surgical stress and earlier mobilization. However, we describe a 47-year-old woman who presented with acute respiratory distress, drowsy consciousness, and circulatory collapse shortly after gynecologic laparoscopic ovariectomy for removing an ovarian teratoma at a local hospital. After resuscitation, the patient was transferred to our emergency department. Immediate bedside electrocardiographic and echocardiographic examination results led to acute pulmonary embolism being quickly diagnosed. The patient received subsequent intensive care with smooth course. Although pulmonary embolism is rare after laparoscopic surgery, early detection and quick treatment are important in the management of this life-threatening complication and offer good prognosis. The risk of pulmonary embolism after gynecologic laparoscopic surgery remains unclear. Therefore, the decision to provide prophylaxis is up to the individual physician, and should take into consideration the patient's individual risk factors and comorbidities.

並列關鍵字

complication ； laparoscopic surgery ； pulmonary embolism

國際替代計量

Acute Pulmonary Embolism Following Laparoscopic Ovariectomy: A Case Report

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