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腹腔镜胆囊切除术后负压性肺水肿:病例报告及文献复习。

Negative pressure pulmonary edema after laparoscopic cholecystectomy: A case report and literature review.

机构信息

Department of Hepatobiliary and Pancreatic Surgery, the People's Hospital of Lezhi, Lezhi, China.

出版信息

Medicine (Baltimore). 2024 Mar 15;103(11):e37443. doi: 10.1097/MD.0000000000037443.

Abstract

RATIONALE

Negative pressure pulmonary edema (NPPE) is an acute onset of non-cardiogenic interstitial pulmonary edema, commonly seen among surgical patients after extubation from general aneasthesia. It is mainly caused by rapid inspiration with acute upper airway obstruction resulting in significant negative thoracic pressure.

PATIENT CONCERNS

A 24-year-old female patient who underwent laparoscopic cholecystectomy under general anesthesia and developed NPPE postoperatively.

DIAGNOSES

Her main clinical manifestation was coughing up pink foamy sputum; postoperative CT showed increased texture in both lungs and bilateral ground glass opacities.

INTERVENTIONS

Diuretics and steroids were used, and symptomatic supportive treatments such as oxygen were given.

OUTCOMES

After treatment, on the fourth post-operative day, her symptoms were relieved and her vital signs were stable enough for her to be discharged.

LESSONS

Although this is a rare and severe complication, the prognosis of NPPE is good when it is managed with proper diagnosis and treatment.

摘要

背景

负压性肺水肿(NPPE)是一种急性发作的非心源性间质性肺水肿,常见于全身麻醉拔管后的外科患者。它主要是由急性上呼吸道阻塞导致的剧烈吸气引起的显著胸腔负压引起的。

病例介绍

一位 24 岁女性患者,在全身麻醉下接受腹腔镜胆囊切除术,术后出现 NPPE。

诊断

主要临床表现为咳出粉红色泡沫痰;术后 CT 显示双肺纹理增多,双侧磨玻璃影。

干预措施

使用利尿剂和类固醇,并给予氧等对症支持治疗。

结果

治疗后,术后第 4 天,患者症状缓解,生命体征稳定,达到出院标准。

结论

尽管这是一种罕见且严重的并发症,但如果得到适当的诊断和治疗,NPPE 的预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba9b/10939698/0593cb5d43e8/medi-103-e37443-g001.jpg

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