| Japanese |
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| Title | 脊髄くも膜下麻酔直前に発症した肺血栓塞栓症を経皮的心肺補助装置PCPSによって救命した一例 |
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| Subtitle | 症例 |
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| Authors | 鮫島千恵子*, 元村紋子*, 星野真里子*, 桜本千恵子*, 外須美夫** |
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| Authors(kana) | |
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| Organization | *町田市民病院麻酔科, **北里大学医学部麻酔科学教室 |
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| Journal | 循環制御 |
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| Volume | 24 |
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| Number | 4 |
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| Page | 386-389 |
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| Year/Month | 2003/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」72歳の女性. 自宅にて転倒した後, 起き上がれなくなり, 右大腿骨頚部骨折と診断された. 受傷から5日後に人工骨頭置換術が予定された. 脊髄くも膜下麻酔を行うために左側臥位になった直後, 心肺停止状態となった. 心肺蘇生を開始したが, 自己心拍が再開しないため経皮的心肺補助装置(Percutaneous Cardiopulmonary SupPort, PCPS)を装着した. 胸部CTにより肺血栓塞栓症(Pulmonaly Thromboembolism, PTE)と診断され, 血栓溶解療法, 抗凝固療法を行った. 恒久的下大静脈フィルターを挿入し, PCPS離脱21日後に再度手術が予定され, 問題なく終了した. 重症PTEを救命するために, PCPSは有用である. PTEの多くは深部静脈血栓症(Deep Vein Thrombosis, DVT)が原因であるため, 術前のDVTの評価, 予防策を行うべきである. 「はじめに」周術期の肺血栓塞栓症(Pulmonaly Thromboembolism, PTE)は生命予後を左右する重篤な合併症であり, 発症1時間以内に10%が死亡する1). ショックに陥った重症例を救命するためには, 速やかに診断, 治療を行い呼吸循環動態を改善させなければならない. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Pulmonary thromboembolism(PTE), Percutaneous cardiopulmonary support(PCPS), Deep vein thrombosis(DVT) |
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| English |
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| Title | A case of Pulmonary Thromboembolism(PTE)Just Before Spinal Anesthesia, Resuscitated with Percutaneous Cardiopulmonary Support(PCPS). |
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| Subtitle | |
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| Authors | Chieko Samejima*, Ayako Motomura*, Mariko Hoshino*, Chieko Sakuramato*, Sumio Hoka** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesia, Machida municipal hospital, **Department of Anesthesiology, Department of Medicine Kitasato university |
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| Journal | Circulation Control |
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| Volume | 24 |
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| Number | 4 |
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| Page | 386-389 |
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| Year/Month | 2003/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 72 year-old woman had a traumatic fracture of the neck of the right femur. At the time of surgical repair of the fractured femur, she suddenly developed cardiopulmonary arrest when turned to the left lateral position for spinal anesthesia. Because of unsuccessful cardiopulmonary resuscitation, PCPS was immediately started. Meantime a diagnosis of pulmonary embolism was made by thoracic CT scan. Then an effective t-PA thrombolysis combined with heparin anticoagulation were carried out, and she was successfully rescued. After uneventful weaning of PCPS and insertion of a permanent IVC filter, the hip operation was performed 21 post-hospital days. From the above experience, we realized that PCPS is essential for saving critically ill patients with PTE and also deep vein thrombosis as a cause of PTE should deeply be paid attention. |
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| Practice | Basic medicine |
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| Keywords | Pulmonary thromboembolism(PTE), Percutaneous cardiopulmonary support(PCPS), Deep vein thrombosis(DVT) |
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