拔除困难：一根 Swan-Ganz 导管盘绕在中心静脉导管上。
Difficult removal: a Swan-Ganz catheter coiled on the central venous catheter.
作者信息
Shen Jian, Ma Luyao, Huang He
机构信息
Department of Anesthesiology, First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, Jiangsu Province, 210029, PR China.
Department of Cardiovascular Surgery, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
出版信息
J Cardiothorac Surg. 2020 May 19;15(1):103. doi: 10.1186/s13019-020-01149-4.
BACKGROUND
The Swan-Ganz catheter plays an important role in gaining understanding of cardiac pathophysiology and in the hemodynamic monitoring of critically ill patients. Difficult removal of the Swan-Ganz catheter is a rare but serious complication.
CASE PRESENTATION
This case presents the difficult removal of a Swan-Ganz catheter in a 28-year-old female patient after cardiac surgery. Fluoroscopy and chest X-ray revealed that a portion of the Swan-Ganz catheter was coiled on the central venous catheter at the level of the superior vena cava. Under X-ray guidance, the central venous catheter was first removed, and then the Swan-Ganz catheter was successfully withdrawn through the percutaneous introducer sheath.
CONCLUSIONS
This case report provides an unreported reason for difficult removal and describes a successful solution. This report suggests that X-ray examinations may be necessary before removing the Swan-Ganz catheter.
背景
Swan-Ganz导管在了解心脏病理生理学以及对危重症患者进行血流动力学监测方面发挥着重要作用。Swan-Ganz导管拔除困难是一种罕见但严重的并发症。
病例报告
本病例呈现了一名28岁女性患者心脏手术后Swan-Ganz导管拔除困难的情况。荧光镜检查和胸部X线显示，Swan-Ganz导管的一部分在上腔静脉水平盘绕在中心静脉导管上。在X线引导下，首先拔除中心静脉导管，然后通过经皮导入鞘成功拔出Swan-Ganz导管。
结论
本病例报告提供了一个未被报道的拔除困难原因，并描述了一个成功的解决方案。本报告表明，在拔除Swan-Ganz导管之前可能需要进行X线检查。
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