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非心脏手术中的术中静脉空气栓塞——围手术期超声心动图在病例系列报告中的作用

Intraoperative venous air embolism in the non-cardiac surgery-the role of perioperative echocardiography in a case series report.

作者信息

Ji Jingjing, Tian Yali, Chen Luning, Li Bingbing

机构信息

Department of Anesthesia, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.

Graduate School of Nanjing University Medical School, Nanjing 210008, China.

出版信息

Ann Transl Med. 2020 Jun;8(12):798. doi: 10.21037/atm-20-497.

Abstract

Venous air embolism (VAE) is commonly one of the iatrogenic complications associated with divergent high-risk surgeries. In this case-series report, we presented a series of VAE cases in our institute during the last 6 consecutive years. There were total of nine cases suspected to be VAE according the clinical symptom and signs, of which seven cases were definitively diagnosed VAE using transthoracic echocardiography (TTE). We also reported two presumptive cases of paradoxical VAE during hepatectomy in this case series, furthermore, the cause, complications and hazards secondary to paradoxical VAE were discussed as well. All cases had an uneventful recovery from VAE with the assistance of TTE as well as other therapeutic management of VAE, except one neurosurgical patient died from postoperative hemorrhagic stroke per se. Therefore, VAE or paradoxical air embolism can occur during various non-cardiac operations and the significance of perioperative ultrasound should be emphasized in the treatment of VAE.

摘要

静脉空气栓塞(VAE)通常是与多种高风险手术相关的医源性并发症之一。在本病例系列报告中,我们呈现了本机构过去连续6年中的一系列VAE病例。根据临床症状和体征,共有9例疑似VAE病例,其中7例通过经胸超声心动图(TTE)被确诊为VAE。在本病例系列中,我们还报告了两例肝切除术中反常VAE的疑似病例,此外,还讨论了反常VAE继发的原因、并发症及危害。除1例神经外科患者死于术后本身的出血性卒中外,所有病例在TTE及其他VAE治疗措施的辅助下均从VAE中顺利康复。因此,VAE或反常空气栓塞可发生于各种非心脏手术期间,围手术期超声在VAE治疗中的重要性应得到重视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7666/7333140/501c7bf87f95/atm-08-12-798-vid1.jpg

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