Fuse Daisuke, Harasawa Hiroshi, Nakamoto Takaaki, Amano Hirohisa, Kobayashi Mikio, Kaneko Noboru
Department of Cardiology and Pneumology, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Sep;40(9):744-8.
A 54-year-old man was admitted to our hospital complaining of sudden-onset dyspnea in shock. Chest computed tomography(CT) showed thrombi in the right main and left intermediate pulmonary arteries. The case was diagnosed as a massive acute pulmonary thromboembolism. Although his hemodynamic status was stable after catecholamine infusion, his dyspnea was still in progress. Emergency pulmonary embolectomy was performed and the life of patient was saved. It is thought that progressive dyspnea is an important sign of a deteriorating hemodynamic status and the predictive symptom indicating a surgical procedure in patients with massive acute pulmonary thromboembolism.
一名54岁男性因突发休克性呼吸困难入院。胸部计算机断层扫描（CT）显示右主肺动脉和左中间肺动脉有血栓。该病例被诊断为大面积急性肺血栓栓塞症。尽管在输注儿茶酚胺后其血流动力学状态稳定，但呼吸困难仍在进展。遂进行了急诊肺动脉血栓切除术，患者生命得以挽救。渐进性呼吸困难被认为是血流动力学状态恶化的重要体征，也是大面积急性肺血栓栓塞症患者手术治疗的预测症状。
