特殊类型的肺栓塞：脓毒性肺栓塞和羊水栓塞。

Unusual pulmonary embolism: septic pulmonary embolism and amniotic fluid embolism.

作者信息

Sakuma Masahito, Sugimura Koichiro, Nakamura Mashio, Takahashi Tohru, Kitamukai Osamu, Yazu Takahiro, Yamada Norikazu, Ota Masahiro, Kobayashi Takao, Nakano Takeshi, Shirato Kunio

机构信息

Division of Internal Medicine, Onagawa Municipal Hospital, Onagawa, Japan.

出版信息

Circ J. 2007 May;71(5):772-5. doi: 10.1253/circj.71.772.

DOI:10.1253/circj.71.772

PMID:17457007

Abstract

BACKGROUND

Septic and amniotic fluid emboli are rare sources of pulmonary embolism (PE), so the present study sought to elucidate the background of these cases.

METHODS AND RESULTS

A total of 11,367 PE cases were identified from 396,982 postmortem examinations. The incidence of septic PE was 247 (2.2%) of the total. The origin of infection was found in 85.6% of the cases. Fungal embolus was detected more often than bacterial embolus. The most frequently detected fungus was aspergillus (20.8%). The primary disease associated with fungal embolus was leukemia (43.2%). The incidence of PE cases associated with pregnancy and/or delivery was 89 (0.8%) of the total PE cases. Among them, amniotic fluid embolism was found in 33 (73.3%) of 45 PE cases with vaginal delivery, and in 7 (21.2%) of 33 PE cases with cesarean delivery (p<0.0001).

CONCLUSION

Fungal embolus was more frequent than bacterial embolus, and leukemia was most frequent as the primary disease in cases of fungal embolus. The main cause of PE in cesarean section cases was thrombotic embolism, and the main cause in vaginal delivery cases was amniotic fluid embolism.

摘要

背景

脓毒性和羊水栓塞是肺栓塞（PE）的罕见病因，因此本研究旨在阐明这些病例的背景情况。

方法与结果

从396,982例尸检中确定了总共11,367例PE病例。脓毒性PE的发生率占总数的247例（2.2%）。85.6%的病例发现了感染源。真菌栓子的检出率高于细菌栓子。最常检测到的真菌是曲霉菌（20.8%）。与真菌栓子相关的主要疾病是白血病（43.2%）。与妊娠和/或分娩相关的PE病例发生率占总PE病例的89例（0.8%）。其中，在45例阴道分娩的PE病例中有33例（73.3%）发生羊水栓塞，在33例剖宫产的PE病例中有7例（21.2%）发生羊水栓塞（p<0.0001）。