Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Korean J Anesthesiol. 2010 Dec;59 Suppl(Suppl):S82-5. doi: 10.4097/kjae.2010.59.S.S82. Epub 2010 Dec 31.
Pulmonary thromboembolism is one of the most important causes of morbidity and mortality in patients undergoing lower extremity orthopedic surgery. Early diagnosis and appropriate management are important clinical challenges. In this case, massive pulmonary embolism causing sudden cardiac arrest was attributed to use of tourniquet inflation during lower extremity orthopedic surgery. Resuscitation procedures were initiated and transesophageal echocardiography revealed pulmonary thromboembolism. Patients with high suspicion for the presence of deep vein thrombus must be monitored thoroughly during limb exsanguinations.
肺血栓栓塞症是下肢骨科手术后患者发病率和死亡率的最重要原因之一。早期诊断和适当的治疗是重要的临床挑战。在本病例中，下肢骨科手术中使用止血带充气导致了大量肺栓塞引起的心脏骤停。开始了复苏程序，经食管超声心动图显示肺血栓栓塞症。对于存在深静脉血栓形成高度怀疑的患者，在肢体放血过程中必须进行彻底监测。
