Kimura Daisuke, Fukuda Ikuo, Tsushima Takao, Sakai Takehiro, Umetsu Satoko, Ogasawara Yukari, Shimamura Norihito, Ohkuma Hiroki
Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Neurosurgery, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Gen Thorac Cardiovasc Surg. 2019 Mar;67(3):306-311. doi: 10.1007/s11748-018-1024-9. Epub 2018 Oct 26.
We analyzed acute ischemic stroke by thromboembolism in the early period after lung cancer surgery.
A retrospective review of the clinical records of patients who underwent lung resection for primary lung cancer was performed. Patients who underwent lobectomy, bilobectomy, and pneumonectomy were included. The clinical characteristics of the patients, the incidence of atrial fibrillation (Af) after surgery, and the incidence of acute ischemic stroke were analyzed. The clinical courses of patients having acute ischemic stroke were also reviewed.
In 4 (0.6%) of 696 patients, acute ischemic stroke occurred in the early period during hospitalization after lung cancer surgery. Acute ischemic stroke occurred within 4 days in three cases and after 4 days in one case. The resection site of the lung was the left side in all cases, and there were three cases of left upper lobectomy and one case of left lower lobectomy. As for the two recent patients, thrombus removal was performed by a neurosurgeon, and both cases achieved successful recanalization. The time between symptom detection and recanalization was 205 and 170 min, respectively. One patient was cured without any residual effect of disease, and the other patient's hemiplegia resolved and aphasia improved.
Since cerebral infarction impairs the patient's quality of life, thrombus removal should be considered if possible.
我们分析了肺癌手术后早期因血栓栓塞导致的急性缺血性卒中。
对接受原发性肺癌肺切除术患者的临床记录进行回顾性研究。纳入接受肺叶切除术、双叶切除术和全肺切除术的患者。分析患者的临床特征、术后房颤（Af）发生率及急性缺血性卒中发生率。对发生急性缺血性卒中患者的临床病程也进行了回顾。
696例患者中有4例（0.6%）在肺癌手术后住院早期发生急性缺血性卒中。3例在4天内发生急性缺血性卒中，1例在4天后发生。所有病例的肺切除部位均为左侧，其中3例行左上叶切除术，1例行左下叶切除术。对于最近的2例患者，由神经外科医生进行了血栓清除，两例均成功再通。症状检测与再通之间的时间分别为205分钟和170分钟。1例患者治愈，无任何疾病残留影响，另1例患者偏瘫消失，失语改善。
由于脑梗死会损害患者的生活质量，如有可能应考虑进行血栓清除。
