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題名 | Massive Pulmonary Embolism during Orthopedic Surgery=骨科手術中發生大量肺栓塞 |
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作者姓名(中文) | 李介宏; 李富榮; 施怡如; 蔡宗杰; 彭士魁; 陸翔寧; 黃仁宣; | 書刊名 | 麻醉學雜誌 |
卷期 | 45:2 2007.06[民96.06] |
頁次 | 頁117-120 |
分類號 | 416.5 |
關鍵詞 | 肺栓塞; 心跳停止; 經食道超音波; Pulmonary embolism; Heart arrest; Echocardiography, transesophageal; |
語文 | 英文(English) |
中文摘要 | 我們報告一位90歲女性因左膝及右髖關節骨折,接受骨科手術治療。在手術當中發生突發性的循環衰竭。經食道超音波發現右心大量栓塞及肺栓塞。經過急救以及抗凝血劑治療,病人恢復穩定,並轉入加護病房治療。我們討論此病況的相關致病機轉,危險因子以及診斷治療方式,並認為經食道超音波是非常有用的診斷工具。 |
英文摘要 | A 90-year-old female patient undergoing surgery for knee and hip fractures under general anesthesia sustained cardiac arrest intraoperatively. The transesophageal echocardiography performed during resuscitation revealed massive pulmonary embolism with a 2×3 cm oval-shaped thrombus in the bifurcation of pulmonary artery. Anticoagulant therapy was administered immediately. Clinical symptoms were gradually improved, and transthoracic echocardiography performed 5 days later revealed no evidence of residual thromboemboli. Subsequently the patient developed liver and acute renal failures in consequence of hypoperfusion during the intraoperative resuscitation, and died of multiple organ failure 21 days after the procedure. We conclude that transesophageal echocardiography is a useful diagnostic instrument and should be utilized in high risk patient as early as possible, even before and during surgery. |
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