经皮椎体成形术后合并骨水泥肺栓塞：1例报道并文献复习

Pulmonary cement embolism following percutaneous vertebroplasty： one case report and literature review

目的提高对经皮椎体成形术后合并骨水泥肺栓塞的认识。方法对1例骨水泥肺栓塞患者的临床资料进行分析，并结合文献复习。结果经皮椎体成形术可合并骨水泥肺栓塞，临床表现为胸痛、呼吸困难、呼吸衰竭等，X线胸片示肺内射线不能透过的管状影。给予吸氧、抗凝及相关支持治疗，病情可好转。结论应提高对经皮椎体成形术后骨水泥肺栓塞的认识，通过积极预防可能减少发生率，确诊后积极治疗可改善预后，对于大的骨水泥肺栓塞应行手术取栓。

Objective To highlight the characteristics of pulmonary cement embolism following percutaneous vertebroplasty. Methods One patient with pulmonary cement embolism was presented and the literature on the subject was reviewed. Results Pulmonary cement embolism may follow with percutaneous vertebroplasty,characterized with chest pain, dyspnea, even respiratory failure. Chest radiography revealed some small tubular radiopacity in the lung. Oxygen aspiration, antieoagulation and other relative support therapies were put to use, the patient made an uneventful recovery. Conclusions This case illustrates that clinicians must be aware of the potential occurrence of pulmonary cement embolism in patients who have received percutaneous vertebroplasty. Precautions are reasonable to avoid or lower the risk of bone cement embolism. Large cement mass is a threat for complete occlusion of the pulmonary artery with subsequent lung infarction,pulmonary embolectomy is proposed to remove the large foreign body.