上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (12): 1561-.doi: 10.3969/j.issn.1674-8115.2012.12.009

• 专题报道（骨关节疾病） • 上一篇    下一篇

关节镜下半月板成形术后并发肺栓塞一例报道

周晓凯, 易诚青, 马春辉, 李 夏, 曹 云   

  1. 上海交通大学附属第一人民医院骨科, 上海 200080
  • 出版日期:2012-12-28 发布日期:2012-12-31
  • 通讯作者: 曹 云, 电子信箱: caoyun3000@126.com。
  • 作者简介:周晓凯（1988—）, 男, 住院医师, 硕士生；电子信箱: orthoxiaokaizhou@gmail.com。

One case report of pulmonary embolism after arthroscopic meniscus angioplasty

ZHOU Xiao-kai, YI Cheng-qing, MA Chun-hui, LI Xia, CAO Yun   

  1. Department of Orthopaedics, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
  • Online:2012-12-28 Published:2012-12-31

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摘要：

肺栓塞（PE）是各种内源性或外源性栓子堵塞肺动脉及其分支引起肺循环功能障碍的一种临床病理综合征，起病隐匿，进展迅速，病死率较高。骨科大手术后深静脉血栓发生率较高，然而膝关节镜术后PE发生鲜有报道，易被忽视，导致严重后果。该文报道了1例关节镜下半月板成形术后发生PE的病例及其抢救过程，并结合相关文献进行分析，认为关节镜下半月板成形术后发生PE可能是由患者的内科基础疾病、术中腘部血管内膜损伤、止血带应用时间过长、手术应激反应以及术后凝血药物的使用等因素导致，需要进行细致的术前评估，熟练轻柔地进行术中操作，术后密切观察下肢及全身情况。

关键词: 关节镜, 半月板成形术, 肺栓塞

Abstract:

Pulmonary embolism (PE) is a clinical syndrome characterized by the dysfunction of pulmonary ventilation caused by all sorts of endogenous and exogenous emboli that clog pulmonary artery and its branches. With its hidden onset and rapid progress, the mortality of PE is higher. It is not rare that deep vein thrombosis occurs after orthopaedic operations, while the incidence of PE after arthroscopy operation is seldom reported, which may be ignored and cause serious consequence. This paper reports one case of PE after arthroscopic meniscus angioplasty. The rescue measures taken for the patient are described, and the related literatures are reviewed. It is considered that the occurrence of PE after arthroscopic meniscus angioplasty may be associated with baseline internal medicine diseases, intraoperative popliteal fossa vascular injury, long time use of tourniquet, operation stress and application of clotting drugs after operation. Therefore, careful preoperative assessment, skilled intraoperative management and close monitoring of lower limbs and general systemic condition after operation are needed.

Key words: arthroscopy, meniscus angioplasty, pulmonary embolism