Stancofski E D, Sardi A, Conaway G L
Department of Surgery, St. Agnes HealthCare, Baltimore, Maryland, USA.
Am Surg. 1998 Nov;64(11):1062-5.
Swan-Ganz catheter-induced pulmonary artery (PA) rupture is rare, with an incidence of 0.016 to 0.2 per cent, but it remains the most dreaded complication in the placement of these catheters with a mortality above 50 per cent. We report two cases of PA rupture after catheter placement. Both patients were managed nonoperatively and without any invasive procedure. They both stopped bleeding after the initial episode and were discharged a few days later. We believe that in the absence of high-risk factors, such as pulmonary hypertension and systemic anticoagulation, PA rupture from a Swan-Ganz catheter can be successfully treated by withdrawal of the catheter and supportive care.
Swan-Ganz导管所致肺动脉破裂较为罕见,发生率为0.016%至0.2%,但仍是此类导管置入过程中最可怕的并发症,死亡率超过50%。我们报告两例导管置入后发生肺动脉破裂的病例。两名患者均未接受手术及任何侵入性操作。他们在初次出血后均停止出血,并于数日后出院。我们认为,在不存在诸如肺动脉高压和全身抗凝等高危因素的情况下,Swan-Ganz导管所致肺动脉破裂可通过拔除导管及支持治疗成功治愈。