摘要
目的通过脑出血后并发急性肺栓塞的病例报道及相关文献复习探讨该病的危险因素、诊治过程和预防策略,提高临床医师对该病的重视及诊疗水平。方法回顾性分析连云港市第一人民医院收治的1例脑出血并发急性肺栓塞患者的资料,复习相关文献。结果患者脑出血后1周确诊急性肺栓塞,给予低分子肝素抗凝治疗,病情缓解,未加重脑出血。脑出血后卧床、肢体制动、使用脱水、利尿、止血等药物是并发肺栓塞的高危因素,临床可通过物理方式及药物来预防静脉血栓栓塞症。结论脑出血后容易并发静脉血栓栓塞症,临床上可通过气压治疗或抗凝药物来减少发生率,治疗上需权衡肺栓塞致死与脑再次出血风险,综合评估后制定个体化治疗方案,在脑出血血肿稳定后使用低分子肝素治疗肺栓塞或许是安全有效的。
Objective To discuss the risk factors,treatment process and prevention strategy of the cases of acute pulmonary embolism after cerebral hemorrhage,so as to improve the attention and level of the disease.Methods The data of a patient with cerebral hemorrhage and acute pulmonary embolism treated in Lianyungang First Peopled Hospital were analyzed retrospectively,and the literature related to intracerebral hemorrhage complicated with acute pulmonary embolism was reviewed.Results One week after intracerebral hemorrhage,the patient was diagnosed with acute pulmonary embolism and given anticoagulant treatment with low molecular weight heparin.The condition was alleviated without aggravating intracerebral hemorrhage.Lying in bed after intracerebral hemorrhage,limb braking,use of dehydration,diuresis,hemostasis and other drugs were the high-risk factors of pulmonary embolism.Venous thromboembolism can be prevented clinically by physical methods and drugs.Conclusions Venous thromboembolism is easy to occur after intracerebral hemorrhage.Clinically,the incidence can be reduced by pneumatic therapy or anticoagulant drugs.In treatment,it is necessary to weigh the risk of death of pulmonary embolism and rebleeding.After comprehensive evaluation,we can formulate an individualized treatment plan.It may be safe and effective to use low molecular weight heparin to treat pulmonary embolism after the intracerebral hemorrhage hematoma is stable.
作者
张嫚
史家欣
李家树
Zhang Man;Shi Jiaxin;Li Jiashu(Department of Respiratory and Critical Care Medicine,Lianyungang First People s Hospital,Lianyungang 222000,China)
出处
《中国医师杂志》
CAS
2021年第10期1487-1491,共5页
Journal of Chinese Physician
基金
国家自然科学基金(81300052)
江苏省青年医学重点人才资助项目(QNRC2016504)
连云港市科技局资助项目(SH1401)。
关键词
脑出血
急性肺栓塞
深静脉血栓
Cerebral hemorrhage
Acute pulmonary embolism
Deep vein thrombosis
