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恶性肺癌患者的Ⅲ级骨水泥植入综合征:一例报告

Grade III bone cement implantation syndrome in malignant lung cancer patient: a case report.

作者信息

Hamal Pawan Kumar, Poudel Puspa Raj, Singh Janith

机构信息

National Academy of Medical Sciences, National Trauma Center, Kathmandu, Nepal.

National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.

出版信息

BMC Anesthesiol. 2018 Mar 2;18(1):28. doi: 10.1186/s12871-018-0492-x.

Abstract

BACKGROUND

Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered.

CASE PRESENTATION

We present a case of 66 years old male patient with metastatic bronchogenic carcinoma of lung with pathological proximal femur fracture of left hip that underwent a cemented endoprosthesis under combined spinal epidural anesthesia who succumbed to intraoperative mortality due to grade III bone cement implantation syndrome even after aggressive fluid resuscitation, vasopressor use, and mechanical ventilation.

CONCLUSIONS

Careful identification of risk factors with aggressive vigilance and intervention in part of surgeons and anesthesia both during intraoperative and postoperative period can mitigate the risk of bone cement implantation syndrome.

摘要

背景

骨水泥植入综合征是一种已知的并发症,在围手术期会导致死亡,尤其是在恶性肿瘤患者中。随着低收入国家恶性肿瘤老年人口的增加,这种综合征更有可能出现。

病例报告

我们报告一例66岁男性患者,患有肺转移性支气管癌,左髋近端股骨病理性骨折,在腰麻-硬膜外联合麻醉下行骨水泥型假体置换术,尽管进行了积极的液体复苏、使用血管升压药和机械通气,但仍因III级骨水泥植入综合征死于术中。

结论

外科医生和麻醉医生在术中和术后仔细识别危险因素并积极警惕和干预,可以降低骨水泥植入综合征的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4055/5833038/2a5e467f0549/12871_2018_492_Fig1_HTML.jpg

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