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一例以意识障碍为首发表现的罕见重症肺栓塞病例。

A rare case of severe pulmonary embolism revealed by consciousness disorders.

作者信息

Wang Jinling, Yang Daowei, Xiu Yibin, Huang Xianwei, Min Xianghui, Li Juan

机构信息

Department of Emergency, Zhongshan Hospital, Xiamen University, Xiamen, China.

Department of Emergency, First Hospital, Xiamen University, Xiamen, China.

出版信息

AME Case Rep. 2020 Oct 30;4:25. doi: 10.21037/acr-20-66. eCollection 2020.

Abstract

Over the several years, only few cases of consciousness was diagnosed as pulmonary embolism in the world. The obstruction of the pulmonary arterial tree is viewed as the source of pulmonary embolism, and eventually trigger the severe cardiopulmonary failure. Diagnosis of pulmonary embolism is dependent on the imaging data, such as the computed tomographic detection. Above 50% of patients with pulmonary embolism are normotensive and they have neither echocardiographic nor laboratory signs of right heart dysfunction. Therefore, the precise prognosis of acute pulmonary embolism presented with rare characteristic is important to improve risk management. In some circumstance, the diagnosis of pulmonary embolism remains a challenge with atypical characterization presented in this case. A case report of this is given to accumulate the diagnostic experience for further analysis. Herein, we report a case of a severe pulmonary embolism that revealed by consciousness disorders. This report highlights the extracorporeal membrane oxygenation (ECMO) could be the only life-sustaining and the possibility of the solution treatment of acute pulmonary embolism.

摘要

在过去几年中,全球仅有少数意识障碍病例被诊断为肺栓塞。肺动脉树的阻塞被视为肺栓塞的根源,并最终引发严重的心肺功能衰竭。肺栓塞的诊断依赖于影像学数据,如计算机断层扫描检测。超过50%的肺栓塞患者血压正常,且没有超声心动图或实验室检查显示的右心功能不全迹象。因此,对于表现出罕见特征的急性肺栓塞,准确的预后判断对于改善风险管理至关重要。在某些情况下,肺栓塞的诊断仍然是一项挑战,本病例就呈现出非典型特征。现给出一例病例报告以积累诊断经验以供进一步分析。在此,我们报告一例因意识障碍而被发现的严重肺栓塞病例。本报告强调了体外膜肺氧合(ECMO)可能是唯一维持生命的手段以及解决急性肺栓塞治疗问题的可能性。

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