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脑动脉造影术后严重肺栓塞的警示:病例报告及文献复习。

Warning of severe pulmonary embolism after cerebral angiography: A case report and literature review.

机构信息

Department of Neurosurgery, The Ningbo Beilun District People's Hospital, Ningbo, China.

Department of Anesthesia, The Ningbo Beilun District People's Hospital, Ningbo, China.

出版信息

Medicine (Baltimore). 2024 Sep 27;103(39):e39635. doi: 10.1097/MD.0000000000039635.

Abstract

RATIONALE

Acute pulmonary embolism (PE), which can lead to cardiac and respiratory arrest, is a rare complication of cerebral angiography. However, neurologists do not pay attention to this.

PATIENT CONCERNS

A 47-year-old male with a history of type 2 diabetes was admitted to our hospital for evaluation of surgical indications for unruptured ophthalmic aneurysms. After cerebral angiography, a fatal PE occurred. Through rapid identification and effective drug treatment, the patient recovered and was discharged.

DIAGNOSES

A diagnosis of fatal PE was made based on the bedside ultrasonography and blood d-dimer level.

INTERVENTIONS

Cardiopulmonary resuscitation and intravenous thrombolysis of "50 mg alteplase" for continuous intravenous drip for 2 hours.

OUTCOMES

The patient was recovered and no special discomfort was reported.

LESSONS

PE is a rare complication of cerebral angiography, but the fatality rate is very high. Neurologists must not only early identify and effectively treat this complication, but more importantly, pay attention to this complication, prevent it in advance, and reduce the occurrence of catastrophic events.

摘要

背景

急性肺栓塞(PE)可导致心搏和呼吸骤停,是脑血管造影术罕见的并发症。然而,神经科医生并未对此给予重视。

病例介绍

一名 47 岁男性,有 2 型糖尿病病史,因未破裂眼动脉瘤的手术适应证入我院。行脑血管造影术后发生致死性 PE。通过快速识别和有效的药物治疗,患者康复并出院。

诊断

根据床旁超声和血 D-二聚体水平诊断为致死性 PE。

干预措施

心肺复苏,给予“50mg 阿替普酶”静脉溶栓,持续静脉滴注 2 小时。

结果

患者康复,无特殊不适。

经验教训

PE 是脑血管造影术罕见的并发症,但病死率非常高。神经科医生不仅要早期识别和有效治疗这种并发症,更重要的是要重视这种并发症,预防其发生,减少灾难性事件的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895a/11441969/e704184562e8/medi-103-e39635-g001.jpg

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