Loke G P Y, Story D A, Liskaser F, Seevanayagam S
Department of Anaesthesia, Austin Health, Heidelberg, Victoria.
Anaesth Intensive Care. 2006 Feb;34(1):75-8. doi: 10.1177/0310057X0603400105.
We report the case of a 20-year-old man with possible Osler-Rendu-Weber syndrome (hereditary haemorrhagic telangiectasia) who developed an episode of massive haemoptysis from a bleeding pulmonary arteriovenous malformation in the left lower lobe of his lung. During the acute haemorrhage, he also appeared to suffer a coronary air embolism, possibly due to introduction of air into the bleeding arteriovenous malformation during intermittent positive pressure ventilation through the endotracheal tube. His electrocardiogram showed extensive ST elevation (>2 mm) in the inferolateral leads associated with raised troponin I and creatine kinase levels. These changes resolved within thirty minutes. The pulmonary arteriovenous malformation was successfully treated with a combination of alcohol injection and coil embolization.
我们报告了一例20岁男性病例，该患者可能患有奥斯勒-伦杜-韦伯综合征（遗传性出血性毛细血管扩张症），因左下肺出血性肺动静脉畸形引发了一次大量咯血。在急性出血期间，他似乎还遭遇了冠状动脉空气栓塞，这可能是由于通过气管插管进行间歇性正压通气时，空气进入了出血的动静脉畸形。他的心电图显示下侧壁导联广泛ST段抬高（>2mm），同时肌钙蛋白I和肌酸激酶水平升高。这些变化在30分钟内得以缓解。通过酒精注射和弹簧圈栓塞联合治疗，成功治愈了该肺动静脉畸形。
