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术中使用过氧化氢继发大量气体栓塞:仍使用这种液体进行冲洗吗?

Massive gas embolism secondary in the use of intraoperative hydrogen peroxide: still use to lavage with this liquid?

作者信息

Benali Zine El Abidine, Abdedaim Hatim, Omari Driss

机构信息

Department of Anesthesiology & Intensive Care, CHP Eddarak, BERKANE, Morocco.

Department of Anesthesiology & Intensive Care, Military Hospital Mohammed V, University Mohammed V Souissi, Rabat, Morocco.

出版信息

Pan Afr Med J. 2013 Nov 29;16:124. doi: 10.11604/pamj.2013.16.124.3499. eCollection 2013.

Abstract

Cases of embolism after using hydrogen peroxide have been described in many circumstances in the operating room. Hydrogen peroxide is not more effective than other antiseptics; its potentially serious risk should not be unrecognized. The alternative use of saline seems very reasonable. The widespread use of hydrogen peroxide by practitioners is explained mainly by its antiseptic effect associated with effervescent backlash visual and auditory, but sometimes the liquid hiding behind a black hole that absorbs the life of the patient in case of inappropriate use. Diagnosis is based on clinical variations in a conscious patient at the time of use, confirmed by echocardiology if available. We related the case of a massive embolism after hydrogen peroxide use in the cleaning of infected wound with osteosynthesis material left femoral done under spinal anesthesia in a young girl of 17 years admitted after to the ICU intubated ventilated.

摘要

在手术室的许多情况下,都有使用过氧化氢后发生栓塞的病例报道。过氧化氢并不比其他防腐剂更有效;其潜在的严重风险不应被忽视。使用生理盐水作为替代似乎非常合理。从业者广泛使用过氧化氢,主要是因为它的防腐作用伴有视觉和听觉上的泡腾反冲,但如果使用不当,有时这种液体就像隐藏在黑洞后的“杀手”,会夺走患者的生命。诊断基于使用时清醒患者的临床变化,如有条件可通过超声心动图进行确认。我们讲述了一名17岁年轻女孩的病例,她在脊髓麻醉下用骨合成材料清理感染伤口时使用了过氧化氢,之后发生了大面积栓塞,随后被送入重症监护病房进行插管通气。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f636/4021982/f19fe93bb195/PAMJ-16-124-g001.jpg

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