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[Diagnosis and treatment for pulmonary thromboembolism in postthoracotomy patients]
Sheng-cai Hou1, Zhen-kui Zhang, Bin Hu
1Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020, China.
Objective:
To report the experience in the diagnosis and treatment of pulmonary thromboembolism (PTE) in postthoracotomy patients and to analyze current problems in this field.
Methods:
From January 2001 to June 2002 we diagnosed and treated 5 patient who had pulmonary thromboembolism, 72-168 hours after thoracotomy (male 4, female 1, mean age 63 years). Symptoms include breathholding, chest pain, palpitation, coma and so on. Physical signs include tachypnea, hypotension and tachycardia. We utilized spiral CT pulmonary artery angiography (SCTPA) and Doppler echocardiography to judge PTE. Pulmonary artery interventional therapy was used in 3 cases and total body thrombolysis in 1.
Results:
4 patients recovered with no complication and recurrence; 1 patient died from congestive heart failure and respiratory failure.
Conclusion:
Deep venous thrombosis (DVT) and PTE are related to the surgical intervention, chest tumor and thoracotomy is high risk factors. Screenage examination is primary to used. Pulmonary artery interventional therapy is safe to the postthoracotomy patients. Preventive measures is very important in the high-risk group.
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