采用静脉-动脉体外膜肺氧合器（ECMO）成功救治导管栓塞术中急性肺动脉栓塞  

作　　者：Ingrid Hailer Agnes Kofler Wolfgang Lederer Andreas Chemelli Franz J. Wiedermann 蒋嘉(译) 岳云(校) 

机构地区：[1]Departments of Anesthesiology and Critical Care Medicine [2]Departments of Radiology, Innsbruck Medical University, Austria [3]不详

出　　处：《麻醉与镇痛》2009年第4期40-42,共3页Anesthesia & Analgesia

摘　　要：在经导管栓塞术中用到的一些活动颗粒可能会不慎进入肺循环，导致严重的肺栓塞。一例36岁女性患者，左肩部有一动静脉畸形，采用徽线圈、正丁基-2-氰丙烯酸盐／碘油和聚乙烯醇颗粒进行栓塞治疗。栓塞期间，突发心动过速、低血压和血氧饱和度下降，提示右心衰竭，血管造影证实肺灌注减少。由于心肺复苏不能稳定其循环功能，对其进行了静脉-动脉体外膜肺氧合治疗直到血流动力学稳定。在经导管栓塞术过程中，肺栓塞引起右心衰竭和心脏停跳的患者应考虑用体外膜肺氧合进行治疗。Versatile particles from transcatheter embolization may accidentally enter the pulmonary circulation, causing severe pulmonary embolism. A 36-yr-old woman patient suffering from an arteriovenous malformation in the left shoulder underwent embolization with micro coils, N-butyl-2-cyanoacrylate/lipiodol and polyvinyl alcohol particles. During embolization, acute onset of tachycardia, hypotension, and decline in oxygen saturation indicated right ventricular failure and decreased pulmonary perfusion confirmed by angiography. As mechanical resuscitation failed to stabilize cardiocirculatory function, veno-arterial extracorporeal membrane oxygenation sup- port was preformed until hemodynamic stability was regained. Extracorporeal membrane oxygenation should be considered for cases where pulmonary embolism causes right ventricular failure and circulatory arrest during transcatheter embolization.

关 键 词：急性肺动脉栓塞 经导管栓塞术 体外膜肺氧合 动静脉畸形 氧合器 救治 栓塞治疗 聚乙烯醇颗粒 

分 类 号：R563.5[医药卫生—呼吸系统] R737.330.5[医药卫生—内科学]