动脉导管未闭封堵术后重度溶血的外科治疗一例  

Surgical treatment of severe hemolysis after transcatheter closure of patent ductus arteriosus: one case report

作　　者：凌霄 万俊[1] 林雪峰[1] 郑少忆[1] 朱鹏 Ling Xiao;Wan Jun;Lin Xuefeng;Zheng Shaoyi;Zhu Peng(Department of Cardiovascular Surgery,Nanfang Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院心血管外科,广州510515

出　　处：《新医学》2021年第10期791-794,共4页Journal of New Medicine

摘　　要：机械性溶血是介入治疗置入封堵器的严重并发症之一,其主要原因是人体血流与粗糙的封堵器表面发生摩擦导致红细胞破裂,可表现为酱油色样尿,伴血红蛋白降低、黄疸等症状,可予降压、补液、糖皮质激素等保守治疗。保守治疗无效时,需及时再次行封堵术或外科手术治疗。该文报道1例动脉导管未闭封堵术后出现重度溶血的46岁女性患者,经保守治疗无效,予创新性手术方式治疗后,症状好转出院。结合相关文献对病例资料进行分析总结,阐述了先天性心脏病封堵术后的并发症及处理方法。该文介绍的手术方式可缩短手术时间及降低操作复杂程度,希望能为广大同行提供一丝灵感或经验。Mechanical hemolysis is one of the serious complications of occluder implantation in interventional therapy, which is mainly caused by the rupture of red blood cells as a result of the severe friction between the red blood cells and the rough surface of the occluder. Patients with mechanical hemolysis exhibit soy sauce-colored urine accompanied by symptoms, such as decreased hemoglobin and jaundice, etc. Mechanical hemolysis can be treated conservative interventions, such as controlled hypotension, fluid replacement and glucocorticoids, etc. When conservative treatment fails, re-occlusion or surgical treatment should be timely performed. In this article, we reported one 46-year-old female patient presenting with severe hemolysis after transcatheter closure of patent ductus arteriosus. Conservative treatment yielded low efficacy, and subsequently innovative surgery was delivered. The patient was recovered and discharged. Combined with relevant literature review, the complications and treatment of congenital heart disease after interventional therapy were illustrated. The procedure introduced in this article significantly shortens the operation time and lowers the surgical complexity, aiming to provide insights or experience for the diagnosis and management of this disease.

关 键 词：动脉导管未闭 封堵术 溶血 外科治疗 

分 类 号：R654.2[医药卫生—外科学]