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急性主动脉夹层后发生大面积肺栓塞一例。病例报告。

An Incident of a Massive Pulmonary Embolism Following Acute Aortic Dissection. a Case Report.

作者信息

Fernandes Sofia, Rodrigues Mariana, Barreiros Catarina, Côrte-Real Hugo, Ferreira Ricardo, Nobre Ângelo

机构信息

Department of Anesthesiology, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Portugal.

Department of Cardiothoracic Surgery, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Portugal.

出版信息

J Crit Care Med (Targu Mures). 2021 Jan 29;7(1):67-72. doi: 10.2478/jccm-2021-0001. eCollection 2021 Jan.

DOI:10.2478/jccm-2021-0001
PMID:34722906
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8519376/
Abstract

Acute aortic dissection and acute pulmonary embolism are two life-threatening emergencies. The presented case is of an 81-year-old man who has been diagnosed with an acute Stanford type A aortic dissection and referred to a tertiary hospital for surgical treatment. After a successful aortic repair and an overall favourable postoperative recovery, he was diagnosed with cervical and upper extremity deep vein thrombosis and was anticoagulated accordingly. He later presented with massive bilateral pulmonary embolism.

摘要

急性主动脉夹层和急性肺栓塞是两种危及生命的急症。本文介绍的病例是一位81岁男性，被诊断为急性斯坦福A型主动脉夹层，并被转诊至一家三级医院接受手术治疗。在成功进行主动脉修复且术后整体恢复良好后，他被诊断出患有颈部和上肢深静脉血栓形成，并据此接受了抗凝治疗。他后来出现了双侧大面积肺栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/aedce8a41814/jccm-07-067-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/18464d71d09b/jccm-07-067-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/37883d734236/jccm-07-067-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/aedce8a41814/jccm-07-067-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/18464d71d09b/jccm-07-067-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/37883d734236/jccm-07-067-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e026/8519376/aedce8a41814/jccm-07-067-g003.jpg

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引用本文的文献

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Br J Cardiol. 2023 Nov 10;30(4):39. doi: 10.5837/bjc.2023.039. eCollection 2023.

本文引用的文献

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Management of acute pulmonary embolism after acute aortic dissection surgery.急性主动脉夹层手术后急性肺栓塞的管理
J Cardiol Cases. 2020 Aug 3;22(4):195-197. doi: 10.1016/j.jccase.2020.06.010. eCollection 2020 Oct.
2
Management of Acute Pulmonary Embolism.急性肺栓塞的管理
JAMA. 2020 Aug 11;324(6):597-598. doi: 10.1001/jama.2020.3905.
3
2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).2019年欧洲心脏病学会（ESC）与欧洲呼吸学会（ERS）合作制定的急性肺栓塞诊断和管理指南。
Eur Heart J. 2020 Jan 21;41(4):543-603. doi: 10.1093/eurheartj/ehz405.
4
Target mortality for repair of acute type A dissection.急性A型主动脉夹层修复的目标死亡率。
J Thorac Cardiovasc Surg. 2019 Apr;157(4):e113-e115. doi: 10.1016/j.jtcvs.2018.09.088.
5
Stroke after emergent surgery for acute type A aortic dissection: predictors, outcome and neurological recovery.急性 A 型主动脉夹层急诊手术后的脑卒中：预测因素、结局和神经功能恢复。
Eur J Cardiothorac Surg. 2018 May 1;53(5):1013-1020. doi: 10.1093/ejcts/ezx465.
6
Consumption coagulopathy in acute aortic dissection: principles of management.急性主动脉夹层中的消耗性凝血病：治疗原则
J Cardiothorac Surg. 2017 Jun 12;12(1):50. doi: 10.1186/s13019-017-0613-5.
7
A systematic approach to improve the outcomes of type A aortic dissection.采用系统方法改善 A 型主动脉夹层的转归。
J Thorac Cardiovasc Surg. 2017 Jul;154(1):89-96.e1. doi: 10.1016/j.jtcvs.2017.03.050. Epub 2017 Mar 23.
8
The hemostatic disturbance in patients with acute aortic dissection: A prospective observational study.急性主动脉夹层患者的止血障碍：一项前瞻性观察研究。
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