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与冠状病毒感染相关的肺血管并发症及肺切除术的作用。

Pulmonary Vascular Complication Associated With Coronavirus Infection and Role of Lung Resection.

机构信息

Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Oregon.

Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Oregon.

出版信息

Ann Thorac Surg. 2023 Apr;115(4):e89-e91. doi: 10.1016/j.athoracsur.2022.04.016. Epub 2022 Apr 25.

DOI:10.1016/j.athoracsur.2022.04.016
PMID:35472408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9035613/
Abstract

Pulmonary artery pseudoaneurysms are an uncommon diagnosis and have been minimally described in the coronavirus (COVID-19) literature. In our case, a 31-year-old man presented with severe acute hypoxic respiratory failure, stress cardiomyopathy, and combined septic and cardiogenic shock secondary to COVID-19 pneumonia and Streptococcus anginosus bacteremia. The patient had perfusing granulomas eroding into the pulmonary vasculature, causing impending hemothorax. Thoracic surgical procedures for infectious pulmonary artery pseudoaneurysms or perfusing granulomas in patients who have had COVID-19 should be performed selectively and with thoughtful perioperative planning to prevent the life-threatening complications of rupture and bleeding.

摘要

肺动脉假性动脉瘤是一种不常见的诊断，在冠状病毒（COVID-19）文献中鲜有描述。在我们的病例中，一名 31 岁男性因 COVID-19 肺炎和咽峡炎链球菌菌血症导致严重急性低氧性呼吸衰竭、应激性心肌病以及合并脓毒性和心源性休克而就诊。患者的血管内有穿透性肉芽肿，侵蚀到肺血管，导致即将发生血胸。对于 COVID-19 患者的感染性肺动脉假性动脉瘤或穿透性肉芽肿，应选择性地进行胸外科手术，并进行周到的围手术期计划，以预防破裂和出血等危及生命的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e0/9035613/ebcd8be643ed/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e0/9035613/ebcd8be643ed/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e0/9035613/ebcd8be643ed/gr1_lrg.jpg

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本文引用的文献

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Pulmonary artery pseudoaneurysm secondary to COVID-19 treated with endovascular embolisation.经血管内栓塞治疗的新型冠状病毒肺炎继发肺动脉假性动脉瘤
Eur J Radiol Open. 2021;8:100346. doi: 10.1016/j.ejro.2021.100346. Epub 2021 Apr 18.
2
Massive hemoptysis due to Aspergillus-related pulmonary artery pseudoaneurysm in a patient with COVID-19 pneumonia.一名新冠肺炎患者因曲霉相关的肺动脉假性动脉瘤导致大量咯血。
Med Intensiva (Engl Ed). 2021 Feb 13;47(3):184-5. doi: 10.1016/j.medin.2021.01.006.
3
Spontaneous hemothorax in 4 COVID-19 ARDS patients on VV-ECMO revealing pulmonary artery aneurysms.
4例接受静脉-静脉体外膜肺氧合治疗的新型冠状病毒肺炎急性呼吸窘迫综合征患者出现自发性血胸，显示存在肺动脉瘤。
Crit Care. 2020 Nov 6;24(1):638. doi: 10.1186/s13054-020-03359-7.
4
Clinical Characteristics of Infections Caused by Streptococcus Anginosus Group.咽峡炎链球菌群感染的临床特征。
Sci Rep. 2020 Jun 3;10(1):9032. doi: 10.1038/s41598-020-65977-z.
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The clinical features of respiratory infections caused by the Streptococcus anginosus group.咽峡炎链球菌群引起的呼吸道感染的临床特征。
BMC Pulm Med. 2015 Oct 26;15:133. doi: 10.1186/s12890-015-0128-6.