病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略...病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略感疼痛,该患者围术期肺栓塞风险高危。诊断方法:CT肺动脉血管成像示双肺段及段以下层面肺动脉多发栓塞。双下肢血管超声示双侧小腿肌静脉内径增宽伴血栓形成(完全填充型)。治疗方法:予抗凝治疗。临床转归:这是1例术前存在下肢深静脉血栓,于部分肾切除术后出现了肺栓塞的病例,予抗凝治疗,患者预后良好。Case Summary: Pulmonary embolism secondary to partial nephrectomy is an extremely rare postoperative complication. This case report describes a 61-year-old female patient with a history of deep vein thrombosis (DVT) in the lower extremities, who was admitted with a diagnosis of “right renal mass for 10 days.” Symptoms and Signs: On the third day following “retroperitoneal laparoscopic partial nephrectomy of the right kidney,” the patient suddenly developed chest tightness, shortness of breath, profuse sweating, and fatigue, with slight pain in the precordial area. This patient was identified as high-risk for perioperative pulmonary embolism. Diagnostic Methods: CT pulmonary angiography revealed multiple emboli in the segmental and subsegmental branches of the pulmonary arteries in both lungs. Bilateral lower extremity vascular ultrasound indicated widened diameters of the calf muscle veins with complete thrombus formation. Treatment Methods: Anticoagulant therapy was administered. Clinical Outcome: This case involves a patient with pre-existing lower extremity deep vein thrombosis who developed a pulmonary embolism following partial nephrectomy. The patient was treated with anticoagulant therapy and had a favorable prognosis.展开更多
病史摘要:气道痉挛和低氧血症是小儿气道异物取出术常见的并发症,本病例报道一例3岁的支气管异物小儿患者行硬质支气管镜后发生气道痉挛和低氧血症,后改为可弯曲支气管镜诊疗的病例。症状体征:其家属代诉患儿食入腰果后当即出现剧烈咳嗽...病史摘要:气道痉挛和低氧血症是小儿气道异物取出术常见的并发症,本病例报道一例3岁的支气管异物小儿患者行硬质支气管镜后发生气道痉挛和低氧血症,后改为可弯曲支气管镜诊疗的病例。症状体征:其家属代诉患儿食入腰果后当即出现剧烈咳嗽,伴憋气,后出现呕吐3次,呕吐物为胃内容物,家属当即行“海姆立克急救法”,未见有异物咳出,持续约40分钟后憋气缓解,后间断咳嗽1 d,无咳痰,无憋喘等症状。诊断方法:胸部CT显示右侧叶支气管分叉处异物,大小约1.0*0.9 cm,右肺阻塞性肺气肿,余气管支气管未见明确异常,诊断为支气管异物、肺气肿(右)。治疗方法:支气管镜异物取出术。临床转归:异物取出后,患儿气管官腔通畅。术后抗感染等对症治疗且无气道痉挛和低氧血症发作,患者预后良好。Medical history abstract: Airway spasm and hypoxemia are common complications of airway foreign body removal in children. This case reports a 3-year-old child with bronchial foreign body who developed airway spasm and hypoxemia after rigid bronchoscopy, and was treated by flexible bronchoscopy. Symptoms and signs: The family members complained that the child had severe cough immediately after eating casheosa, accompanied by shortness of breath, and then had vomiting for 3 times, and the vomit was stomach contents. The family members immediately performed the “Heimlich first aid” method, and no foreign body was coughed out. After about 40 minutes, the breath was relieved, and then the child coughed intermittently for 1 day, without expectoration or choking. Chest CT showed a foreign body (1.0*0.9 cm) at the bifurcation of the right bronchus, with obstructive emphysema in the right lung, and no clear abnormalities in the rest of the tracheobronchus. The diagnosis was bronchial foreign body and emphysema (right). The treatment was bronchoscopic foreign body removal. Clinical outcome: The tracheal lumen was patent after remova展开更多
文摘病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略感疼痛,该患者围术期肺栓塞风险高危。诊断方法:CT肺动脉血管成像示双肺段及段以下层面肺动脉多发栓塞。双下肢血管超声示双侧小腿肌静脉内径增宽伴血栓形成(完全填充型)。治疗方法:予抗凝治疗。临床转归:这是1例术前存在下肢深静脉血栓,于部分肾切除术后出现了肺栓塞的病例,予抗凝治疗,患者预后良好。Case Summary: Pulmonary embolism secondary to partial nephrectomy is an extremely rare postoperative complication. This case report describes a 61-year-old female patient with a history of deep vein thrombosis (DVT) in the lower extremities, who was admitted with a diagnosis of “right renal mass for 10 days.” Symptoms and Signs: On the third day following “retroperitoneal laparoscopic partial nephrectomy of the right kidney,” the patient suddenly developed chest tightness, shortness of breath, profuse sweating, and fatigue, with slight pain in the precordial area. This patient was identified as high-risk for perioperative pulmonary embolism. Diagnostic Methods: CT pulmonary angiography revealed multiple emboli in the segmental and subsegmental branches of the pulmonary arteries in both lungs. Bilateral lower extremity vascular ultrasound indicated widened diameters of the calf muscle veins with complete thrombus formation. Treatment Methods: Anticoagulant therapy was administered. Clinical Outcome: This case involves a patient with pre-existing lower extremity deep vein thrombosis who developed a pulmonary embolism following partial nephrectomy. The patient was treated with anticoagulant therapy and had a favorable prognosis.
文摘病史摘要:气道痉挛和低氧血症是小儿气道异物取出术常见的并发症,本病例报道一例3岁的支气管异物小儿患者行硬质支气管镜后发生气道痉挛和低氧血症,后改为可弯曲支气管镜诊疗的病例。症状体征:其家属代诉患儿食入腰果后当即出现剧烈咳嗽,伴憋气,后出现呕吐3次,呕吐物为胃内容物,家属当即行“海姆立克急救法”,未见有异物咳出,持续约40分钟后憋气缓解,后间断咳嗽1 d,无咳痰,无憋喘等症状。诊断方法:胸部CT显示右侧叶支气管分叉处异物,大小约1.0*0.9 cm,右肺阻塞性肺气肿,余气管支气管未见明确异常,诊断为支气管异物、肺气肿(右)。治疗方法:支气管镜异物取出术。临床转归:异物取出后,患儿气管官腔通畅。术后抗感染等对症治疗且无气道痉挛和低氧血症发作,患者预后良好。Medical history abstract: Airway spasm and hypoxemia are common complications of airway foreign body removal in children. This case reports a 3-year-old child with bronchial foreign body who developed airway spasm and hypoxemia after rigid bronchoscopy, and was treated by flexible bronchoscopy. Symptoms and signs: The family members complained that the child had severe cough immediately after eating casheosa, accompanied by shortness of breath, and then had vomiting for 3 times, and the vomit was stomach contents. The family members immediately performed the “Heimlich first aid” method, and no foreign body was coughed out. After about 40 minutes, the breath was relieved, and then the child coughed intermittently for 1 day, without expectoration or choking. Chest CT showed a foreign body (1.0*0.9 cm) at the bifurcation of the right bronchus, with obstructive emphysema in the right lung, and no clear abnormalities in the rest of the tracheobronchus. The diagnosis was bronchial foreign body and emphysema (right). The treatment was bronchoscopic foreign body removal. Clinical outcome: The tracheal lumen was patent after remova
