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目的分析脊柱手术后并发肺栓塞的临床特点,探讨早期诊断、治疗方法。方法1995年1月至2006年5月,在我院接受脊柱手术患者10993例,其中术后出现肺栓塞患者11例。回顾性分析该11例患者的临床特点及诊断、治疗方式。结果脊柱术后肺栓塞占同期我院脊柱手术总数的0.1%;出现肺栓塞的时间为术后5～14 d(平均9.8d),患者可见呼吸困难、心悸、胸痛、咯血等特征性肺栓塞症状;本组死亡5例,死亡率45.5%。早期使用肺动脉造影明确诊断、早期经肺动脉导管介入治疗可以显著降低死亡率。结论肺栓塞是脊柱手术后的严重并发症,术后1～2周是致死性肺栓塞的高危时段,死亡率高;肺动脉造影与介入治疗在早期诊断、治疗中占有重要地位。
Objective To analyze the clinical characteristics of pulmonary embolism after spine surgery and to discuss the early diagnosis and treatment methods. Methods From January 1995 to May 2006, 10 993 patients underwent spine surgery in our hospital, including 11 patients with pulmonary embolism. Retrospective analysis of the 11 patients with clinical features and diagnosis and treatment. Results Pulmonary embolism accounted for 0.1% of the total number of spine surgery in our hospital during the same period. The time of pulmonary embolism was 5 ~ 14 days after operation (mean 9.8 days) .Patients with dyspnea, heart palpitations, chest pain, hemoptysis and other characteristic pulmonary embolism Symptoms; 5 patients died in this group, the mortality rate of 45.5%. Early use of pulmonary arteriography to confirm the diagnosis of early pulmonary intervention can significantly reduce the mortality rate. Conclusions Pulmonary embolism is a serious complication after spine surgery. One to two weeks after operation is the high risk period of fatal pulmonary embolism with high mortality rate. Pulmonary arteriography and interventional therapy play an important role in early diagnosis and treatment.