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在用过氧化灌后,同时发生气体栓塞和肺:一个罕见的病例报告
1Department of Anesthesiology and Surgery, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu, China.
International journal of surgery case reports
|February 17, 2024
概括
在脊椎手术期间不适当使用过氧化 (H2O2) 可以导致致命的气栓塞和肺脑. 这一案例凸显了用H2O2灌注深层伤口或腔的关键风险,强调了手术环境中的谨慎.
科学领域:
- 神经外科 神经外科
- 心脏病学 心脏病学
- 医疗紧急情况.
背景情况:
- 气栓塞是一种罕见但危及生命的并发症.
- 过氧化 (H2O2) 灌深层伤口或封闭腔的危险性.
- 组织中的catalase迅速将H2O2分解为氧和水,可能导致气体栓塞.
研究的目的:
- 报告一个罕见的同时致命气栓塞和肺脑病的罕见病例.
- 为了突出在脊椎外科手术中使用手术内过氧化的风险.
- 为了强调在手术过程中使用H2O2时需要谨慎.
主要方法:
- 一名患有腰部结核和副脊椎的患者接受了脊椎手术.
- 过氧化 (3%v/w) 用于灌腹腔脱bridement后.
- 灌后立即发生心肺骤停,需要复苏和诊断成像.
主要成果:
- 经食道心声扫描显示了右心腔中广泛的"雪花状"气栓塞.
- 部CT扫描显示了前额叶的多点肺脑病.
- 尽管进行了复苏,但患者脑死亡,这表明死亡是致命的.
结论:
- 在脊椎手术中过氧化灌可以导致快速释放气体,导致血管阻塞和内肺炎.
- 气体栓塞和肺脑病的同时发生非常罕见,但具有破坏性.
- 在手术期间,避免在闭腔或深度/大伤口中使用H2O2,以防止致命的并发症.
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