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[使用纤维蛋白胶栓塞血管瘤后可能发生的肺栓塞]

[Possible lung embolism following embolization of a hemangioma with fibrin glue].

作者信息

Tonner P H, Scholz J

机构信息

Abteilung für Anästhesiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.

出版信息

Anaesthesist. 1994 Sep;43(9):614-7. doi: 10.1007/s001010050100.

Abstract

More than 50% of all congenital haemangiomas are located on the head and neck. Because most orofacial haemangiomas exhibit the tendency to grow rapidly, they are often treated by embolisation and excision. CASE REPORT. The case of a 5-year-old patient is presented, who was admitted to the hospital for embolisation and immediate surgery of a haemangioma of the right side of the face and upper lip. After the injection of 2 ml fibrin glue she suddenly developed hypotension, tachycardia, a low oxygen saturation, and a low end-tidal carbon dioxide partial pressure. There was no failure of the breathing circuit and no airway obstruction could be found. Most likely these symptoms were due to transport of the fibrin glue from the haemangioma into pulmonary vessels. The therapy included the administration of heparin and antihypotensive drugs. After stabilisation, the patient was transferred to the intensive care unit for 1 day without further complications. CONCLUSION. Pulmonary embolism after injection of fibrin glue into an orofacial haemangioma has not previously been reported, but it should be considered that systemic complications can occur after injecting substances for embolisation into vessel-rich tissues.

摘要

超过50%的先天性血管瘤位于头颈部。由于大多数口腔颌面部血管瘤有迅速生长的趋势,它们常通过栓塞和切除进行治疗。病例报告。本文介绍了一名5岁患者的病例,该患者因右侧面部和上唇血管瘤的栓塞及即刻手术入院。注射2毫升纤维蛋白胶后,她突然出现低血压、心动过速、低氧饱和度和低潮气量二氧化碳分压。呼吸回路无故障,未发现气道阻塞。这些症状很可能是由于纤维蛋白胶从血管瘤进入肺血管所致。治疗措施包括给予肝素和抗低血压药物。病情稳定后,患者被转至重症监护病房1天,未出现进一步并发症。结论。此前尚未报道过向口腔颌面部血管瘤注射纤维蛋白胶后发生肺栓塞的情况,但应考虑到向血管丰富的组织注射栓塞物质后可能会出现全身并发症。

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