Massive Hemothorax after Central Venous Cannulation

從內頸靜脈或鎖骨下靜脈置入中心靜脈導管的方式，係常用於治療重症病人的途徑。雖然動脈穿刺與氣胸是較常見的併發症，但大量血胸則很少發生。中心靜脈導管穿過血管，跑進胸腔內則更少見。在本文中述及一位產後大量出血的病人，於置入中心靜脈導管後引致血胸。雖然經過輸血與搶救，由於持續血壓過低無法提昇，不幸地於手術過程中死亡。她的死因主要是由於未能完成治療大量血胸與產後大量出血。本人以為，於置入中心靜脈導管過程中，須保持高度警覺。置入動作完成後，另須以X光確定置入位置。

關鍵字

血胸；中心靜脈導管置入；併發症；內頸靜脈

並列摘要

Central venous cannulation via the internal jugular vein or subclavian vein is commonly used in the treatment of critically ill patients. Although arterial puncture and pneumothorax are well-known complications of central venous cannulation, hemothorax, especially when massive, is relatively uncommon. The central catheter passing through a blood vessel into the chest cavity is rare. We present a patient with postpartum hemorrhage who developed a massive hemothorax as a complication of central venous cannulation. She died in the operating room because of intractable blood loss, in spite of vigorous blood and fluid resuscitation. Death was attributed to a massive, untreatable hemothorax and postpartum hemorrhage. We recommend that central venous cannulation should be performed very cautiously, and a chest x-ray must be obtained shortly after the procedure to look for possible complications.

並列關鍵字

hemothorax ； central venous cannulation ； complications ； internal jugular vein

國際替代計量

Massive Hemothorax after Central Venous Cannulation

全文下載

主題瀏覽