Suzuki Kazumasa, Takamatsu Kousei, Takano Takehisa, Tanabe Youichirou, Fujiyama Ko, Matsuoka Hiroo
Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.
J ECT. 2008 Dec;24(4):286-8. doi: 10.1097/YCT.0b013e31816c434a.
We encountered 2 patients with a psychiatric disorder (depression in one and catatonia in one) accompanied by motor inhibition that was complicated by pulmonary embolism (PE). In both cases, the psychiatric disorder was safely resolved with electroconvulsive therapy (ECT) during anticoagulant therapy. The 2 cases direct our attention to at least 3 important points regarding safe administration of ECT shortly after the occurrence of PE, that is, careful evaluation of cardiac function and residual deep vein thrombosis before the start of an ECT course, adjustment of anticoagulants, and prevention of recurrent deep vein thrombosis and PE by methods in addition to anticoagulant therapy (fluid infusion, use of support hose, and timely ECT).
我们遇到了2例患有精神障碍(1例为抑郁症,1例为紧张症)并伴有运动抑制的患者,这些患者并发了肺栓塞(PE)。在这两例中,精神障碍在抗凝治疗期间通过电休克疗法(ECT)安全地得到了解决。这2例病例使我们关注到关于PE发生后不久安全实施ECT的至少3个要点,即ECT疗程开始前仔细评估心脏功能和残余深静脉血栓形成,调整抗凝剂,以及通过抗凝治疗以外的方法(输液、使用弹力袜和及时进行ECT)预防深静脉血栓形成和PE复发。