中心静脉导管拔除后静脉空气栓塞1例  

Venous air embolism following removal of central venous catheters: A case report

作　　者：万利 张周沧[1] 丁嘉祥[1] 王梅[2] WAN Li;ZHANG Zhoucang;DING Jiaxiang;WANG Mei(Department of Nephrology,Peking University International Hospital,Beijing 102206,China;Department of Nephrology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学国际医院肾脏内科,北京102206 [2]北京大学人民医院肾内科,北京100044

出　　处：《北京大学学报（医学版）》2024年第5期938-941,共4页Journal of Peking University:Health Sciences

摘　　要：空气栓塞是一种罕见的可危及生命的疾病^([1]),其中静脉空气栓塞是血液透析和使用中心静脉导管的潜在并发症^([2])。本文报道1例中心静脉导管拔除后静脉空气栓塞患者的诊疗过程,并对静脉空气栓塞的发病机制、诊断、治疗、预后及预防措施进行文献复习,以提高认识。1 病例资料患者为女性,59岁。Air embolism is a rare but dreaded complication of medical or surgical procedures with significant mortality.An abnormal air-to-blood pressure gradient and communication between the vein and atmosphere can lead to the venous air embolism.Here,we presented a rare case of venous air embolism just after the removal of the central venous catheters.A 59-year-old female was admitted to Peking University International Hospital suffering from neuromyelitis optica spectrum disorder.After 5 rounds of immunosorbent therapy,her hemodialysis catheter was removed.Five hours later,she suddenly experienced shortness of breath,dizziness,weakness of the lower extremities,transient loss of consciousness and seizures.Ultrasound showed a small amount of gas in the right internal jugular vein and brain CT showed scattered air accumulation in part of venous blood ducts and bilateral cavernous sinuses,which was diagnosed as air embolism.High-flow oxygen inhalation,compression of the right neck extubation site,head down and feet up left decubitus position,intravenous fluid therapy were used.The patient gradually improved and returned to normal activities after one week.To sum up,air embolism is a rare,but serious and life-threatening complication after central catheters removal.Clinicians need to be alerted and take appropriate preventive measures.

关 键 词：中心静脉导管插入术 空气栓塞 并发症 预防 

分 类 号：R459.5[医药卫生—治疗学]