在PMMA脊椎造形术后出现症状性肺水泥栓塞:临床表现和管理
Haytham Najjar1,2, Hind Neiroukh3, Layth J M Saada3,4
1Internal Medicine Department, Indiana University School of Medicine-muncie, Indiana, USA.
肺水泥栓塞 (PCE) 是脊椎形成术的一种罕见并发症. 通过胸部CT进行早期检测对于在术后出现呼吸道症状的患者至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 放射学 放射学是指放射学
- 肺部病理学 肺部病理学
背景情况:
- 脊椎造形术使用聚甲基甲酸盐 (PMMA) 骨水泥来稳定脊椎.
- 肺水泥栓塞 (PCE) 是一种不常见的并发症,PMMA进入肺循环.
- PCE的发病率在2.1%至26%之间,往往诊断不足和无症状.
研究的目的:
- 突出脊柱手术后症状性PCE的诊断挑战.
- 强调高临床怀疑的重要性,对于未解释的呼吸道症状后脊椎造形术.
主要方法:
- 一个71岁的女性患有脊柱狭窄的案例介绍.
- 涉及PMMA水泥增强固定的手术干预.
- 诊断确认使用非对比的胸部CT.
主要成果:
- 患者在手术后三天出现严重的呼吸道症状 (呼吸暂停,低氧症).
- 胸部CT显示了双边高密度的不透明度,与肺动脉中的PMMA栓塞一致.
结论:
- 在脊柱仪器仪表后,症状性PCE诊断可能具有挑战性.
- 非对比的胸部CT是怀疑PCE的首选诊断工具.
- 用氧气和抗凝剂进行保守的治疗通常对症状患者有效.
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