查詢結果分析
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頁籤選單縮合
題名 | Cardiac Tamponade from a Central Venous Catheter in an Obstetric Patient=產科病患接受中央靜脈導管術引發心包膜墳塞 |
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作者 | 沈中章; 許德耀; 張旭陽; | 書刊名 | 臺灣婦產科醫學會會刊雜誌 |
卷期 | 42:2 2003.06[民92.06] |
頁次 | 頁133-136 |
分類號 | 415.3164 |
關鍵詞 | 中央靜脈導管術; 心包膜填塞; Central venous catheter; Cardiac tamponade; |
語文 | 英文(English) |
中文摘要 | 目的:心包膜填塞如果未接受積極而適當的治療會導致高死亡率。我們在此報告一位產科病患進行中央靜脈導管術,因上腔靜脈穿刺破裂導致心包膜填塞。病例報告:一位32歲孕婦因完全性前置胎盤及前胎剖腹產接受剖腹產。手術中發現黏生性胎盤及大量出血,因此接受緊急子宮切除術。患者術後裝置中央靜脈導管以利於血行動力的評估及輸血,病患進行中央靜脈導管術時因上腔靜脈穿刺破裂導致心包膜填塞及休克,經緊急照會心臟科醫師後立即給予心包膜穿刺術,術後患者血壓漸趨穩定情況好轉於一星期後出院,經過三個月的追蹤亦無後遺症。結論:產科醫師進行中央靜脈導管術時,必需清楚了解其可能的術後併發症。若發現中央靜脈導管術有困難且導致休克時,必需懷疑心包膜穿刺破裂導致心包膜填塞的可能。唯有正確而迅速的治療心包膜填塞,才能避免悲劇的發生。 |
英文摘要 | Objective: Cardiac tamponade has a high mortality rate if aggressive and proper therapeutic measures are not undertaken. Herein we report a case of cardiac tamponade secondary to perforation of the superior vena cava by a central venous catheter in an obstetric patient. Case Report(s): A 32-year-old woman underwent a cesarean section due to placenta previa totalis and a previous cesarean section. An emergency peripartum hysterectomy was performed due to placenta accreta and intractable hemorrhage. A central venous catheter was inserted for hemodynamic monitoring and blood transfusion. Cardiac tamponade occurred secondary to perforation of the superior vena cava by the central venous catheter. The patient’s hemodynamic status became stable after pericardiocentesis. One week later she was discharged with no sequelae during the three month follow-up. Conclusion(s): Obstetricians should remain alert for the possibility of postoperative complications. Difficulty in inserting of a central venous catheter should raise suspicions of possible pericardial disruption or other complications. Prompt recognition and treatment of cardiac tamponade are imperative if a disastrous outcome is to be prevented. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。