Malpositioned Central Venous Catheter in the Main Pulmonary Artery Trunk-A Case Report

中心靜脈導管異位置放於主肺動脈幹內－一病例報告

林瑞原(Jui-Yuan Lin) ； 郭炳宏(Ping-Hung Kuo) ； 陳晉興(Jin-Shing Chen)

《胸腔醫學》 24卷1期 (2009/02) Pp. 68-73

https://doi.org/10.29806/TM.200902.0010

摘要

置放中心靜脈導管可以提供血液動力學的資訊與作為快速輸注液體和治療製劑的管道。有許多種中心靜脈導管置放術的併發症，包括異位、動脈穿刺、氣胸、血胸、乳糜胸、縱隔血腫、鄰近的神經受傷、輸注物外滲出血管、血栓靜脈炎和感染。中心靜脈導管置放過程中造成血管受傷包括多種併發症，其中以動脈穿刺為最常見。我們報告一個67歲女性合併深度的敗血性休克，在試圖建立中心靜脈導管過程中，將導管意外地放置在主肺動脈幹內。中心靜脈導管藉由實行微型胸廓切開術而移除。極少量氣胸與些許紅色肋膜積液被發現。術後的血液動力學狀況穩定。我們回顧了有關中心靜脈導管置放過程中造成的併發症與肺動脈受傷相關之文獻報告。

關鍵字

中心靜脈導管 ； 異位 ； 肺動脈

並列摘要

Central venous catheterization may provide hemodynamic information and act as a route for the rapid infusion of fluids and therapeutic agents. The complications of central venous cannulation are numerous. Vascular injuries during central venous catheter (CVC) insertion encompass a wide spectrum of complications, with arterial puncture being the most common. We report a 67-year-old woman with profound septic shock in whom the main pulmonary artery trunk was accidentally cannulated during an attempt to establish central venous access. Mini-thoracotomy for CVC removal was performed. Minimal pneumothorax and some reddish pleural effusion were found. The postoperative hemodynamic status was stable. We also reviewed the related literature on complications and pulmonary artery injury during central venous catheterization.

並列關鍵字

central venous catheter ； malposition ； pulmonary artery