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題 名 | 股靜脈鞘斷落--病例報告暨處理新概念=Intravenous Fragmented Femoral Sheath--A Case Report and A New Concept of Management |
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作 者 | 吳懿哲; 吳協兆; 周友三; 蔡正河; | 書刊名 | 內科學誌 |
卷 期 | 12:2 2001.04[民90.04] |
頁 次 | 頁83-87 |
分類號 | 416.26 |
關鍵詞 | 血管; 異物; 心導管; 氣球; Blood vessels; Foreign body; Cardiac catheterization; Balloon; |
語 文 | 中文(Chinese) |
中文摘要 | 血管異物或斷落物的發生,於此導管發達的年代偶有所聞。大靜脈或右心房內之 斷落物若不加以取出,約有七成的比例可造成嚴重併發症,包括死亡。另外,週邊靜脈之異 物在進行取出時,常可隨血流向心移行至右心房、右心室,甚或肺動脈,增加取出時之困難 度與危險性。如何防止異物之向心移行,目前尚有相關文獻論及。本文報導一位 64 歲男性 ,於執行左側股靜脈電極導管放置時,不慎造成股靜脈鞘 (femoral sheath) 斷落,為防止 其向心移行, 本病例首度使用一週邊動脈血管成形術 (PTA) 氣球,由右側股靜脈置入至左 側總腸骨靜後予以充氣, 隨後利用心肌組織夾 (myocardial biopsy forceps) 及鼻夾 (antrum punch) 成功將斷落之靜脈鞘取出。我們認為使用 PTA 氣球防止周邊靜脈異物向心 移為一簡便且安全之方法,能使操作者在使用各種方式進行異物移出時,大大增加其安全性 與穩定性。 |
英文摘要 | Intravascular foreign bodies are occasionally encountered in this catheterization era. Retention of fragmented catheter in central vein or right trium may result in serious complications in about 70% of patients On the other hand, the foreign bodies in peripheral veins, while being retrieved, may migrate proximally into right atrium, right ventricle, or even pulmonary artery, increasing the diffiulty and the risk of retrieval. To our knowledge, there has been or report regarding the prevention of proximal migration of venous foreign bodies. The current presentation reports an inadvertent fragmentation of femoral sheath in a 64-year-old man during manipulation of a venous catheter. We introduced a percutaneous trasnluminal angioplasty (PTA) ballon from the contralateral femoral vein to the ipsilateral common iliac vein, and inflated balloon to prevent proximal migration of the fragmented femoral seath, which was later successfully retrieved by a myocardial biopsy forceps and an antrum punch. Thgis is the first case using PTA balloon to prevent proximal migration of venous foreign body. This simple management would allow operator to retrieve foreignbody in a much safer way. |
本系統中英文摘要資訊取自各篇刊載內容。