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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13054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2～6d,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。
Objective To analyze the clinical features of pulmonary embolism after liver resection and summarize the experience of clinical diagnosis and treatment and the prevention and treatment strategies. Methods From January 2005 to December 2009, 13054 liver cancer patients undergoing liver resection in our hospital were recruited. Among them, 4 patients had pulmonary embolism after operation. The clinical features, pathogenesis, diagnosis and treatment of the 4 patients were retrospectively analyzed. Results The number of cases of pulmonary embolism after hepatectomy accounted for 0.03% of the cases of liver resection in our hospital during the same period. The time of pulmonary embolism was 2 ~ 6 days after operation. The patients showed dyspnea, cyanosis, chest tightness, palpitation, sudden death and blood oxygen Pressure (PaO2), oxygen saturation (SaO2) decreased pulmonary embolism symptoms. One patient (25%) died. Conclusions Pulmonary embolism is a serious complication after hepatectomy. The diagnosis of chest X-ray and D-Dimer in emergency can be diagnosed early and once diagnosed, it must be treated immediately.