Vintila Bogdan I, Bereanu Alina S, Codru Ioana R, Achim David, Bancila Stefan A, Sava Mihai
Anesthesia and Critical Care, County Clinical Emergency Hospital, Sibiu, ROU.
Anesthesia and Critical Care, Faculty of Medicine, Lucian Blaga University, Sibiu, ROU.
Cureus. 2024 Jul 18;16(7):e64786. doi: 10.7759/cureus.64786. eCollection 2024 Jul.
Around the world, lung cancer is the leading cause of cancer-related death and the most commonly diagnosed cancer. In the early stages, surgery is the preferable therapeutic strategy. We present the case of a male patient aged 49 years diagnosed with non-small cell lung cancer of the left lower lobe who was referred for a radical left pneumonectomy. After careful preoperative preparation, the surgery was proceeded with. During the surgery, the patient needed bronchoscopy for the aspiration of the trachea and bronchial tree; after the aspiration procedure, an intraoperative massive hemorrhage started, with shock and ventricular tachycardia. Nine days after surgery, the patient developed a pulmonary embolism and returned to the ICU. The patient benefited from transfusion, intrathoracic cardiac compressions, pulse index continuous cardiac output (PiCCO), renal replacement therapy (RRT), anticoagulation, and intensive care. After a complicated clinical course, the patient is discharged, and after more than 18 months, the patient comes regularly for follow-up consultation in good health.
在全球范围内，肺癌是癌症相关死亡的主要原因，也是最常被诊断出的癌症。在早期阶段，手术是首选的治疗策略。我们报告一例49岁男性患者，被诊断为左肺下叶非小细胞肺癌，转诊接受根治性左肺切除术。经过仔细的术前准备后，手术开始进行。手术过程中，患者需要进行支气管镜检查以抽吸气管和支气管树；抽吸操作后，术中出现大量出血，并伴有休克和室性心动过速。术后九天，患者发生肺栓塞并返回重症监护病房（ICU）。患者接受了输血、胸内心脏按压、脉搏指示连续心输出量监测（PiCCO）、肾脏替代治疗（RRT）、抗凝治疗和重症监护。经过复杂的临床过程后，患者出院，18多个月后，患者健康状况良好，定期前来进行随访咨询。
