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[一例胸腔内巨大慢性扩展性血肿的外科病例]

[A surgical case for the huge chronic expanding hematoma developed in the thoracic cavity].

作者信息

Maniwa Y, Okada M, Ishii N, Yoshida M, Sakamoto T, Harada N

机构信息

Department of Surgery, Kobe University School of Medicine, Japan.

出版信息

Kyobu Geka. 1997 Nov;50(12):1069-73.

PMID:9388359
Abstract

We report a case of operation against chronic expanding hematoma developed in the pleural cavity of the patient who were treated as anaplastic anemia. 69-year-old man had been underwent thymectomy because of the thymoma and hemogenic pleural effusion 8 years ago. Then, last year, he was pointed out severe thrombocytopenia and underwent transfusion of thrombocyte. In the same period, chest X-ray examination revealed development of the tumor-like shadow in the left lung field. The abnormal shadow has enlarged, so the patient admitted us. X-ray findings revealed the huge tumor occupied completely the left pleural space. He was also pointed out severe pancytopenia (WBC: 2,600/mm3, RBC: 172 x 10(4)/mm3, thrombocyto: 1.9 x 10(4)/mm#), and the examination of bone marrow revealed anaplastic anemia. Thoracotomy was underwent, and the tumor was resected. Pathological diagnosis of the tumor was huge hematoma. Negative pressure in the pleural space would keep the hemorrhage and make hematoma huge. The hematoma in the pleural space should be resected as soon as the diagnosis is decided.

摘要

我们报告一例针对一名被诊断为再生障碍性贫血患者胸腔内慢性扩展性血肿的手术病例。一名69岁男性8年前因胸腺瘤和血性胸腔积液接受了胸腺切除术。去年,他被诊断为严重血小板减少症并接受了血小板输注。同期,胸部X线检查显示左肺野出现肿瘤样阴影。该异常阴影逐渐增大,因此患者入院。X线检查发现巨大肿瘤完全占据了左胸腔。他还被诊断为严重全血细胞减少症(白细胞:2600/mm³,红细胞:172×10⁴/mm³,血小板:1.9×10⁴/mm³),骨髓检查显示为再生障碍性贫血。患者接受了开胸手术,并切除了肿瘤。肿瘤的病理诊断为巨大血肿。胸腔内的负压会持续导致出血并使血肿增大。一旦确诊,应尽快切除胸腔内的血肿。

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