Fatal Pulmonary Embolism During Bipolar Hemiarthroplasty: A Case Report and Literature Review

雙極人工股骨頭置換術過程中發生致命的肺栓塞：病例報告及文獻回顧

黃國生(Kuo-Sheng Huang) ； 馬振來(Chen-Lai Ma) ； 張錦新(Kam-Sun Cheung) ； 陳耀舜(Yiu-Sion Chen) ； 王亮傑(Liang-Chieh Wang) ； 文寄銘(Kee-Ming Man)

《童綜合醫學雜誌》 11卷1期 (2017/06) Pp. 31-34

摘要

Pulmonary embolism (PE) is a well-documented complication of orthopedic trauma. Multiple studies have provided data on the prevalence of PE, the probability of death from a PE, and the risk factors for PE development after lower extremity and pelvic trauma. Venous thromboembolism (VTE) during hemiarthroplasty is considered a relatively rare phenomenon but can be a dangerous and life-threatening condition. Here we report a case of a 56-year-old woman who died from PE resulting from lower limb deep vein thrombosis during hemiarthroplasty under spinal anesthesia. This case raises awareness of the need for precautions against VTE following orthopedic surgery and shed light on the identification of high-risk patients. We also review the current literature and recommendations for prophylaxis against VTE.

關鍵字

Pulmonary embolism ； venous thromboembolism ； intraoperative complications ； bipolar hemiarthroplasty

並列摘要

肺栓塞是骨科手術中的一個已有充分證據的併發症。多個肺栓塞的研究已提供了關於肺栓塞的患病率，死亡率和下肢和骨盆創傷後危險因子的數據。靜脈血栓栓塞發生在人工股骨頭置換術被認為是一種相對較少的現象，但可以是一個危險和威脅生命的併發症。我們報告一位56 歲的女性在腰椎麻醉下進行人工股骨頭置換，過程中由於下肢深靜脈血栓引起致命的肺栓塞。這案例提高我們對骨科手術和辨別高風險患者對於靜脈血栓栓塞的防範意識。我們也檢討現行的文獻和建議對靜脈血栓栓塞的預防方法。

並列關鍵字

肺栓塞 ； 靜脈血栓栓塞 ； 術中併發症 ； 雙極人工股骨頭置換術