通过手术治疗的急性肺栓塞并因肺动脉伪动脉瘤而复杂:一个病例报告
Arthur Dumont1, Gaby Aphram2, Francesca Chiara Della Casa3
1Department of Cardiology, Université Catholique de Louvain, Brussels, BEL.
Cureus
|December 1, 2025
概括
手术性肺血栓切除术 (SPT) 为急性肺栓塞 (PE) 提供了一个可行的替代方案,当其他治疗方法失败时. 这个案例突出了复杂的PE案例中成功的SPT,随后进行了文献审查.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 干预性放射学 干预性放射学
背景情况:
- 急性肺栓塞 (PE) 是一种常见的疾病,具有显著的死亡率.
- 标准的治疗方法,如抗凝血和血栓溶解有限制或禁忌.
- 带有心内血栓的大量PE具有系统栓塞的高风险.
研究的目的:
- 要呈现一个带有移动性心内血栓的亚质量PE病例,用手术肺血栓切除术 (SPT) 治疗.
- 讨论 SPT 后的并发症 (伪动脉瘤) 的管理.
- 审查最近关于SPT对急性PE的疗效和安全性的文献.
主要方法:
- 一个48岁的女性患有亚大质量PE和心内血栓的病例报告.
- 手术性肺血栓切除术 (SPT) 是由于其他治疗方法的禁忌而进行的.
- 通过内血管栓塞进行术后伪动脉瘤的管理.
- 关于急性PE的SPT近期进展的文献综述.
主要成果:
- 进行了成功的手术肺血栓切除术 (SPT).
- 一个术后的伪动脉瘤成功地用内血管栓塞治疗.
- 患者在接受抗凝药治疗的三个月内完全康复.
- 观察到的术后死亡率和SPT并发症率是可以接受的,低于预测.
结论:
- 手术性肺血栓切除术 (SPT) 是一种有价值的,尽管未得到充分利用的选择,用于选择急性肺栓塞 (PE) 病例.
- 即使在复杂的表现中,SPT也可以安全地进行,并获得可接受的结果.
- 手术和干预技术的进步正在提高SPT的安全性和有效性.
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