Caeymaex L, Durand P, Lambert V, Retbi J M, Devictor D
Service de réanimation pédiatrique, hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Arch Pediatr. 2000 Aug;7(8):851-4. doi: 10.1016/s0929-693x(00)80196-7.
A diagnosis of pulmonary embolism is uncommon in the infant and the child, and chronic cor pulmonale secondary to pulmonary embolism is an even rarer occurrence.
In this study, a case of pulmonary embolism in a 6-month-old male infant has been reported. His past history included preterm birth, and severe bronchopulmonary dysplasia, with prolonged oxygen dependency. The positive diagnosis was based on cardiac ultrasound examination, with the direct imaging of a right pulmonary arterial thrombus. Surgical thromboendarterectomy was performed, with a long-term favorable outcome.
After excluding from the diagnosis those hemostatic disorders known to be thrombogenic, the most likely hypothesis was retained, i.e., that it was catheter-related. A central venous catheter had been inserted during the neonatal period, and was probably responsible for the embolism. The clinical characteristics and the diagnostic and therapeutic aspects of chronic postembolic cor pulmonale have been discussed in the light of the present findings.
婴儿和儿童患肺栓塞的诊断并不常见，继发于肺栓塞的慢性肺源性心脏病则更为罕见。
在本研究中，报告了一例6个月大男婴患肺栓塞的病例。他既往有早产史，患有严重支气管肺发育不良，长期依赖氧气。阳性诊断基于心脏超声检查，直接成像显示右肺动脉血栓。进行了外科血栓内膜剥脱术，取得了长期良好效果。
在排除已知有血栓形成倾向的止血障碍后，保留了最可能的假设，即与导管相关。新生儿期曾插入中心静脉导管，可能是栓塞的原因。根据目前的研究结果，讨论了慢性栓塞后肺源性心脏病的临床特征以及诊断和治疗方面。
