丙泊酚注射液致下肢血栓性静脉炎  

Lower extremity thrombophlebitis caused by propofol injection

作　　者：张欣[1] 方圣博 周娜[2] Zhang Xin;Fang Shengbo;Zhou Na(Department of Pharmacy, the First Hospital of Jilin University, Changchun 130021, China;Department of Pharmacy, Hospital of Stomatology, Jilin University, Changchun 130021, China)

机构地区：[1]吉林大学第一医院药学部,长春130021 [2]吉林大学口腔医院药剂科,长春130021

出　　处：《药物不良反应杂志》2019年第4期295-296,共2页Adverse Drug Reactions Journal

摘　　要：1例27岁男性患者因左上颌骨根尖周囊肿全麻下行左上颌骨肿物摘除术。术中,自患者左下肢外周静脉建立静脉通路,给予诱导和维持性麻醉药物(丙泊酚注射液,氯化琥珀胆碱注射液,注射用盐酸瑞芬太尼,盐酸右美托咪定注射液)。术后第2天,患者左下肢沿血管走行出现局部红肿,渐发展为条索状红肿,血管硬度增加。经血管超声检查,诊断为左大隐静脉血栓性静脉炎。给予皮下注射依诺肝素钠,口服马栗种子提取物,局部外用多磺酸粘多糖乳膏,理疗等。术后第10天,患者左下肢红肿消失,血管软化。随访2个月,血管超声检查提示左大隐静脉主干(小腿段)部分再通。根据药品说明及文献报道,考虑患者此次血栓性静脉炎可能与丙泊酚注射液有关。A 27-year-old male patient underwent left maxillary masses excision for periapical cysts in the left maxillary under general anesthesia. During the surgery, a venous access was established from the peripheral vein of the patient′s left lower extremity, and anesthetic drugs (propofol injection, succinylcholine chloride injection, remifentanil hydrochloride for injection, dexmedetomidine hydrochloride injection) were given. On day 2 after surgery, the patient developed topical redness and swelling along the blood vessel on his left lower extremity, which gradually developed into a cord-like redness and swelling, with increased blood vessel stiffness. He was diagnosed with thrombophlebitis of the left great saphenous vein after a ultrasound examination of the blood vessel. Treatments such as subcutaneous injection of enoxaparin sodium, oral administration of extract of horse chestnut seeds, topical mucopolysaccharide polysulfate cream, physiotherapy, and etc. were given. On day 10 after surgery, the redness and swelling on the patient′s left lower extremity disappeared, and the blood vessel was softened. At 2 months of follow-up, ultrasound examination revealed partial recanalization of the left venous trunk (the calf part) of saphenous vein. According to the drug labels and literature reports, it was considered that the patient′s thrombophlebitis might be associated with propofol injection.

关 键 词：丙泊酚 静脉炎 血栓性静脉炎 麻醉 

分 类 号：R969[医药卫生—药理学]