现代管理大规模的肺栓塞和同时发生的III级骨撕裂
Bret K Farrow-Cypel1, Muhammad Mian1, Alex Galante2
1Internal Medicine Residency Program, AtlantiCare Regional Medical Center, Atlantic City, New Jersey, USA.
JACC. Case reports
|December 12, 2025
概括
管理大规模肺栓塞 (PE) 与活跃出血需要仔细评估风险. 用导管导向的血栓切除和栓塞为血液动力学恢复提供了可行的解决方案,同时最大限度地降低了出血风险.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
背景情况:
- 肺栓塞 (PE) 是心血管死亡的重要原因之一.
- 活跃出血是一个挑战,往往排除了血栓溶解药物治疗.
研究的目的:
- 描述一个复杂的PE病例与同时发生的脏损伤的成功管理.
- 突出多学科团队在高风险PE管理中的作用.
主要方法:
- 一名患有巨大的双边PE和骨撕裂的患者接受了治疗.
- 对于PE,进行了导管导向的血栓切除术,随后进行了脏动脉栓塞.
- 使用了暂时的抗凝中断和IVC过器的放置.
主要成果:
- 导管导向的血栓切除术导致显著的血液动力学改善.
- 脏动脉栓塞成功控制了出血.
- 在恢复抗凝血药物和移除IVC过器后,患者完全康复.
结论:
- 在复杂的PE中,平衡出血风险和再输血需求至关重要.
- 导管干预和栓塞可以实现血液动力恢复,降低出血风险.
- 多学科,个性化的护理对于高危PE患者至关重要.
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