- 期刊
Postoperative Right Atrial and Pulmonary Embolism after Prolonged Spinal Surgery
長時間脊椎手術後産生右心房血栓及肺血管栓塞
摘要
手術前後發生右心房血栓及肺血管栓塞是很罕見的，而迅速且正確的診斷更是困難。我們將報告一病例，接受時間脊椎手術在送到恢複室後有心搏過速及血流動力不穩定的徵象。在懷疑手術中産生深部靜脈血栓的疑似診斷下，在恢複室中用經食道超音波確定診斷有右心房血栓及肺血管栓塞。雖然經緊急心臓手術，進行心切開(cardiotomy)及血栓清除(thrombecyomy)手術，病人仍然死亡。在此病例報告中，我們將討論有關的危險因子、預防、診斷及治療方式。
並列摘要
Perioperative pulmonary thromboembolism can proceed rapidly with grave prognosis, in which immediate or accurate diagnosis and managment is not easy. According to the literatures, patients receiving spinal surgery are at relatively lower risk of developing thromboembolism. We would like to present a case of postoperative pulmonary thromboembolism which developed after a prolonged lumbar spinal surgery. Tachycardia and unstable hemodynamics were noted postoperatively. Pulmonary and right atrial thrombi were disclosed by transesophageal echocardiography. Although cardiotomy and thrombectomy were immediately performed, the patient finally died 3 days after the operation. The pathogenesis of venous thromboembolism (VTE) in the surgical patients, the risk factors which predispose a patient to VTE, diagnosis, and treatment as well as the prophylactic measures of VTE are herein reviewed and discussed.
延伸閱讀
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