手术中应用局部止血药后发生血栓栓塞、急性右心衰竭和弥散性血管内凝血

局部止血药通常用于脊柱外科手术以控制或减少出血。目前市场上有多种局部止血药可选用，我院使用的局部止血药是加入牛凝血酶的可吸收明胶粉剂（Surgifoam^TM）。我们报道一例脊柱侧凸畸形患者进行后路椎体融合矫形术，手术中发生可能是由于血管内误入局部止血药诱发的血栓栓塞，导致急性右心衰竭、心脏停搏以及弥散性血管内凝血（DIC）。临床医生必须警惕局部止血药引起的潜在的致命性并发症。

Topical hemostatic agents are frequently used in spine surgeries to control or reduce bleeding. Although there are a number of commercially available products, at our institution, an absorbable gelatin powder （Surgifoam.） is mixed with bovine thrombin and used for this purpose. We report the case of a patient undergoing a posterior spinal fusion for scoliosis who developed acute right heart failure, cardiac arrest, and disseminated intravascular coagulation after probable intravascular hemostatic agentinduced emboli. Clinicians need to be aware of this potentially deadly complication associated with topical hemostatic agents.