Liu Furong, Yang Song, Liu Weishuo, Tang Baiyun, Zhang Wenbo, Zhang Cheng, Liao Wenwei, Hu Anbin
1 Department of Cardiac Surgical Intensive Care, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
2 Department of Pathology of the First Affiliated Hospital of Soochow University, Suzhou, China.
J Int Med Res. 2018 Aug;46(8):3440-3445. doi: 10.1177/0300060518778120. Epub 2018 Jun 12.
Carbon monoxide (CO) poisoning, the most frequent type of poisoning, alters hemodynamics and creates tissue hypoxia that ultimately leads to thromboembolism. We herein describe a previously healthy 17-year-old male patient who developed acute CO poisoning while bathing in the same room as a gas heater. He was first treated with urokinase thrombolytic therapy at a local hospital, which proved ineffective. The patient was admitted to our hospital with unstable circulation and was diagnosed with massive pulmonary embolism combined with multiple organ dysfunction syndrome. His Acute Physiology and Chronic Health Evaluation II score was 22, and his Sequential Organ Failure Assessment score was 15. We faced a difficult decision regarding whether to perform surgical embolectomy or to repeat the thrombolysis. We opted to repeat the thrombolysis with successful results. Our experience may help clinicians manage similar cases in the future.
一氧化碳（CO）中毒是最常见的中毒类型，它会改变血液动力学并导致组织缺氧，最终引发血栓栓塞。我们在此描述一名此前健康的17岁男性患者，他在与燃气热水器同一房间洗澡时发生急性CO中毒。他最初在当地医院接受了尿激酶溶栓治疗，但证明无效。该患者因循环不稳定入住我院，被诊断为大面积肺栓塞合并多器官功能障碍综合征。他的急性生理与慢性健康状况评估II（APACHE II）评分是22分，序贯器官衰竭评估（SOFA）评分是15分。对于是进行手术取栓还是重复溶栓，我们面临艰难抉择。我们选择重复溶栓并取得了成功。我们的经验可能有助于临床医生未来处理类似病例。
