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肺叶切除术是脑梗死的栓塞危险因素,即使在术后长期阶段也是如此。

Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction, Even in the Long-term Postoperative Phase.

机构信息

Department of Neurology, Nagano Municipal Hospital, Japan.

Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan.

出版信息

Intern Med. 2023 Nov 15;62(22):3401-3404. doi: 10.2169/internalmedicine.1529-22. Epub 2023 Apr 7.

Abstract

The vein stump created after lung lobectomy has been reported to cause thrombus and subsequently cerebral infarction. However, its assessment after a long-term postoperative course remains unreported. The pulmonary vein stump is a structure near the left atrial appendage; therefore, such patients may be at a constant risk of thrombus formation. We herein report two cases of cerebral infarction associated with lung lobectomy. Transesophageal echocardiography revealed mobile thrombi in the pulmonary vein stump. Both patients had cancer recurrence, and hypercoagulability may have contributed to thrombus formation. This vein stump should be investigated as an embolic source, even after a long postoperative duration.

摘要

肺叶切除术后遗留的静脉残端可导致血栓形成,进而引发脑梗死。然而,其在长期术后过程中的评估尚未见报道。肺静脉残端位于左心耳附近,因此此类患者可能持续存在血栓形成的风险。本文报告了 2 例与肺叶切除相关的脑梗死病例。经食管超声心动图显示肺静脉残端存在活动性血栓。这 2 例患者均存在癌症复发,高凝状态可能导致血栓形成。即使在长期术后,也应将此静脉残端作为栓子来源进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0f4/10713374/8949513c51a7/1349-7235-62-3401-g001.jpg

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