| 摘要: |
| 目的 分析肝脏肿瘤肝切除术后并发肺栓塞的临床特点,总结临床诊治经验及防治策略。方法 2005年1月至2009年12月,在我院接受肝切除的肝脏肿瘤患者13 054人次,其中术后出现肺栓塞患者4例。回顾性分析该4例患者的临床特点及发病机制、诊断和治疗方式。结果 肝切除术后并发肺栓塞例数占同期我院肝切除例数的0.03％；出现肺栓塞时间为术后2～6 d,患者表现为呼吸困难、紫绀、胸闷、心慌、猝死及血氧分压(PaO2)、氧饱和度(SaO2)下降等肺栓塞症状。1例(25％)患者死亡。结论 肺栓塞是肝切除术后的严重并发症,急诊胸部X片和D-Dimer检测可早期明确诊断,一旦确诊必须立即处理。 |
| 关键词: 肝肿瘤 肝切除术 手术后并发症 肺栓塞 |
| DOI：10.3724/SP.J.1008.2010.00 |
| 投稿时间：2010-02-11修订日期：2010-04-23 |
| 基金项目: |
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| Diagnosis and treatment of pulmonary embolism secondary to hepatectomy in patients with hepatic tumors |
| YIN Lei, LI Ai-jun, PAN Ze-ya, FU Si-yuan, , WU Meng-chao,ZHOU Wei-ping* |
| (The Third Hepatic Surgery Department, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China) |
| Abstract: |
| Objective To analyze the clinical characteristics of pulmonary embolism(PE) after hepatectomy in patients with hepatic tumors, and to summarize our experience on the diagnosis, treatment and prevention of the condition. Methods From Jan.2005 to Dec. 2009, a total of 13,054 person-times with hepatic tumor underwent hepatectomy in our hospital, and 4 cases developed PE after hepatectomy. The clinical characteristics, pathogenic mechanism, diagnosis and treatment of the 4 patients were retrospectively analyzed. Results The incidence of PE was 0.03％ after hepatectomy in the present cohort. PE developed from day 2 to day 6 after hepatectomy; the symptoms included shortness of breath, cyanosis, chest distress, cardiopalmus, sudden death, and decrease of oxygen partial pressure(PaO2) and saturation of blood oxygen(SaO2). One (25%) of the 4 patients died. Conclusion PE is a serious complication after hepatectomy for hepatic tumor. Emergent chest X-ray and D-Dimer examination can make early and clear diagnosis; the condition should be managed once it is confirmed. |
| Key words: liver neoplasms hepatectomy postoperative complications pulmonary embolism |
