在例行脉冲场肺静脉隔离后,意外的急性损伤需要透析:一个病例报告
Bart A Mulder1, Michele F Eisenga2, Mark Eijgelsheim2
1Department of Cardiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands.
European heart journal. Case reports
|January 21, 2026
概括
对心房的脉冲场切除可以导致急性损伤 (AKI),即使应用较少. 警和及时干预对于这种手术后的脏恢复至关重要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗器械 医疗器械
背景情况:
- 使用脉冲场切除 (PFA) 的肺静脉隔离 (PVI) 是对心房动 (AF) 的新治疗方法.
- 血液溶解诱导的急性损伤 (AKI) 是PFA的潜在并发症,特别是在众多应用中.
研究的目的:
- 在使用PFA导管进行PVI后报告严重的AKI病例.
- 为了突出AKI的风险,尽管PFA应用数量有限,血液溶解最小.
主要方法:
- 一名62岁的男性有冠状动脉旁路移植 (CABG) 病史,使用35毫米五线PFA导管进行了PVI.
- 采用标准的能量输送协议,每静脉进行两次应用,共40次应用.
- 患者出现了AKI的症状,包括暗色的尿液,体重增加和寡尿症,需要紧急透析.
主要成果:
- 该患者经历了严重的AKI,估计球透率 (eGFR) 为6mL/min/1.73m2,需要进行血液透析.
- 实验室检测显示尿液中血解标志物和红细胞分解产物升高.
- 透析后两个月,功能恢复到正常值.
结论:
- 严重的AKI需要透析可以发生在PFA后,即使在70次以下的应用和最小的全身血液溶解.
- 提高警,早期流体管理和及时干预对于支持PFA手术后脏恢复至关重要.
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