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重症监护病房中的半体切除术：一例复杂病例报告

Hemicorporectomy in the ICU: a complex case report.

作者信息

Kocayiğit Havva, Can Burcu, Sağlam Fevzi, Erdem Ali Fuat

机构信息

Department of Anesthesiology and Reanimation, Sakarya University School of Medicine, Sakarya, Turkey.

Department of Orthopaedic and Traumatology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey.

出版信息

BMC Anesthesiol. 2025 Jul 1;25(1):304. doi: 10.1186/s12871-025-03184-x.

DOI:10.1186/s12871-025-03184-x
PMID:40597622
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210823/
Abstract

UNLABELLED

This case report presents the intensive care management of a 65-year-old male patient who underwent hemicorporectomy due to advanced intrapelvic chordoma. Early postoperative complications included supraventricular tachycardia, ventilator-associated pneumonia, and sepsis, while late complications involved wound infection, fluid management challenges, and pleural effusion. Candida parapsilosis was isolated from the wound site, and clinical improvement was achieved with antifungal therapy. After a two-month intensive care stay, the patient was stabilized and transferred to the orthopedic department. This report highlights the importance of a multidisciplinary approach and intensive care management following hemicorporectomy.

GRAPHICAL ABSTRACT

[Image: see text]

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12871-025-03184-x.

摘要

未标注

本病例报告介绍了一名65岁男性患者的重症监护管理情况，该患者因晚期盆腔内脊索瘤接受了半体切除术。术后早期并发症包括室上性心动过速、呼吸机相关性肺炎和败血症，而晚期并发症涉及伤口感染、液体管理挑战和胸腔积液。从伤口部位分离出近平滑念珠菌，抗真菌治疗取得了临床改善。经过两个月的重症监护，患者病情稳定并转至骨科。本报告强调了半体切除术后多学科方法和重症监护管理的重要性。

图形摘要

[图像：见正文]

补充信息

在线版本包含可在10.1186/s12871-025-03184-x获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/f4f04461b2c3/12871_2025_3184_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/23db8c6dd540/12871_2025_3184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/999b709fc2ef/12871_2025_3184_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/ae496c0584ec/12871_2025_3184_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/ac2162a9df65/12871_2025_3184_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/f4f04461b2c3/12871_2025_3184_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/23db8c6dd540/12871_2025_3184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/999b709fc2ef/12871_2025_3184_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/ae496c0584ec/12871_2025_3184_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/ac2162a9df65/12871_2025_3184_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12210823/f4f04461b2c3/12871_2025_3184_Fig5_HTML.jpg

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本文引用的文献

1
Pelvic crush injury requiring hemicorporectomy.需要进行半体切除术的骨盆挤压伤。
Trauma Surg Acute Care Open. 2021 Jul 15;6(1):e000740. doi: 10.1136/tsaco-2021-000740. eCollection 2021.
2
Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room.在混合急诊室进行损伤控制介入放射学治疗后，采用半体切除术成功治疗开放性骨盆骨折伴双侧髂总动静脉损伤。
Acute Med Surg. 2020 Oct 29;7(1):e575. doi: 10.1002/ams2.575. eCollection 2020 Jan-Dec.
3
Spinal Cord Stimulation for Treatment Refractory Stump Pain Following Pelvic Trauma Hemicorporectomy: Case Report.
脊髓刺激治疗骨盆创伤半体切除术后难治性残端痛：病例报告
Neuromodulation. 2020 Jul;23(5):713-715. doi: 10.1111/ner.13055. Epub 2019 Nov 5.
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The effect of nebulized salbutamol on atrial electrical properties in mechanically ventilated critically ill patients - a randomized, double-blind study.雾化沙丁胺醇对机械通气重症患者心房电特性的影响——一项随机、双盲研究。
Anaesthesiol Intensive Ther. 2018;50(4):270-276. doi: 10.5603/AIT.a2018.0031. Epub 2018 Sep 22.
5
Hemicorporectomy as a life-saving strategy for severe pelvic ring crush injury: a case report.半体切除术作为严重骨盆环挤压伤的一种挽救生命的策略：一例病例报告
Eur J Orthop Surg Traumatol. 2018 May;28(4):735-739. doi: 10.1007/s00590-018-2140-z. Epub 2018 Feb 10.
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Traumatic extremity amputation in a Nigerian setting: patterns and challenges of care.在尼日利亚，创伤性肢体截肢：护理模式和挑战。
Int Orthop. 2012 Mar;36(3):613-8. doi: 10.1007/s00264-011-1322-7. Epub 2011 Jul 22.
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Salbutamol misuse or abuse with fatal outcome: a case-report.沙丁胺醇误用或滥用导致死亡：病例报告。
Hum Exp Toxicol. 2011 Nov;30(11):1869-71. doi: 10.1177/0960327110388957. Epub 2010 Dec 7.