Yi Inho, Park Joo Chul, Cho Kyu Seok, Kim Bum Shik, Kim Soo-Cheol, Kim Dae Hyun, Kim Jung-Heon, Youn Hyo Chul
Department of Thoracic and Cardiovascular Surgery, Mokpo Hankook Hospital, Korea.
Korean J Thorac Cardiovasc Surg. 2011 Oct;44(5):343-7. doi: 10.5090/kjtcs.2011.44.5.343. Epub 2011 Oct 6.
Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism.
Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicatedfor mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state.
The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure.
Emergency operation should be performed when medical treatments are no longer effective.
急性肺血栓栓塞症因突然发生的低氧血症和右心衰竭而致命。有多种治疗方式，包括抗凝、溶栓、体外膜肺氧合（ECMO）和血栓栓子切除术，用于处理急性肺血栓栓塞症。
回顾性分析我院1999年1月至2004年12月期间接受肺血栓栓子切除术的病历。共有7例患者（4例男性，3例女性），共进行了8次手术，因为1例患者术后复发栓塞并接受了再次手术。手术适用于轻度低氧血症，在心脏跳动状态下通过体外循环（CPB）进行。
患者有多种症状，如呼吸困难、胸部不适和心悸。4例患者有深静脉血栓栓塞，3例有精神问题，具体为精神分裂症。术后并发症包括血胸、胸腔积液和心包积液。有2例医院死亡，分别死于脑死亡和右心衰竭。
当药物治疗不再有效时，应进行急诊手术。
