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严重肺栓塞继发于经皮椎体成形术后骨水泥致下腔静脉栓塞

Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty.

作者信息

Yuan Zhaoshun, Zhou Yangzhao, Zhou Xinmin, Liao Xiaobo

机构信息

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Ann Vasc Surg. 2018 Apr;48:255.e1-255.e3. doi: 10.1016/j.avsg.2018.01.003. Epub 2018 Feb 9.

Abstract

Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occurred simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. Patient's symptom and image tests manifest that the cPE was secondary to cIE. Although cIE was found at the first day after PVP, the local surgeons treat the patient with a regular anticoagulant without another more effective therapeutic measure. Eventually, the long cement inferior vena cava embolus was broken and result in left pulmonary embolism via the systemic circulation. She was admitted to our hospital and performed with embolectomy surgery by cardiopulmonary bypass and discharged after 7 days. We report this case to show that cIE embolism is still underestimated by some spine surgeons in China, and cIE may be developed to severe cPE during conservation management with anticoagulation.

摘要

骨水泥肺栓塞(cPE)和下腔静脉栓塞(cIE)是经皮椎体成形术(PVP)罕见但可能危及生命的并发症。大多数cPE和cIE同时发生。在本病例中,一名65岁女性在PVP术后4天出现呼吸困难。患者的症状和影像学检查表明cPE继发于cIE。尽管在PVP术后第一天就发现了cIE,但当地外科医生仅用常规抗凝剂治疗患者,未采取其他更有效的治疗措施。最终,长段骨水泥下腔静脉栓子破裂,经体循环导致左肺栓塞。她被收入我院,通过体外循环进行了栓子切除术,术后7天出院。我们报告此病例以表明,cIE栓塞在中国一些脊柱外科医生中仍未得到充分重视,并且在抗凝保守治疗期间,cIE可能发展为严重的cPE。

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