Nawata S, Tomozawa N, Nishida K, Moritani K, Hisamatsu Y
Department of Surgery, Ehime Rosai Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):153-8.
A 72-year-old female, who had received medication for hypertension and angina pectoris was hospitalized with complaining of an abrupt dyspnea. Roentgenogram of the chest revealed no abnormal findings except cardiac enlargement. An electrocardiogram showed overloading of the right ventricle. Arterial blood gas analysis of room air showed 55.4 mmHg of PaO2, 25.5 mmHg of PaCO2 and 7.30 of PH, respectively. Acute and massive pulmonary embolism was diagnosed by an emergent pulmonary arteriography. Despite intensive treatment such as infusion of urokinase and heparin for four days, thrombus was still detected in the left main pulmonary artery by a transesophageal echocardiography. By the result of ineffective conservative therapy, embolectomy was performed under cardiopulmonary bypass. However mechanical respiratory support was required for a long time due to the right heart failure, she is doing well for a year after the operation.
一名72岁女性，因高血压和心绞痛接受药物治疗，因突发呼吸困难入院。胸部X光片除心脏增大外未见异常。心电图显示右心室负荷过重。室内空气动脉血气分析显示，动脉血氧分压（PaO2）为55.4 mmHg，动脉血二氧化碳分压（PaCO2）为25.5 mmHg，pH值为7.30。通过紧急肺动脉造影诊断为急性大面积肺栓塞。尽管进行了如尿激酶和肝素输注等四天的强化治疗，但经食管超声心动图仍在左主肺动脉检测到血栓。由于保守治疗无效，在体外循环下进行了栓子切除术。然而，由于右心衰竭，需要长时间的机械通气支持，术后一年她恢复良好。
