喉癌、喉咽癌手术相关肺血栓栓塞症的临床特点

Clinical features of postoperative pulmonary thromboembolism associated with laryngeal and hypopharyngeal carcinoma

目的探讨喉癌、喉咽癌手术相关肺血栓栓塞症的临床特点及其诊断和预防。方法对11例喉癌、喉咽癌术后确诊为肺血栓栓塞症患者的临床表现、辅助检查、治疗方法等进行回顾性分析。结果同期行喉癌手术453例、喉咽癌手术134例,其中11例术后确诊并发肺血栓栓塞症,占1.9%;临床表现以憋气、胸闷为主,确诊方法包括螺旋CT肺动脉造影8例、核素肺通气/灌注显像确诊3例;主要采用抗凝治疗。结论喉癌、喉咽癌手术相关肺血栓栓塞症并不少见,应予高度警惕,手术前评估和围手术期预防十分重要。

Objective To analyze the clinical characteristics of pulmonary thromboembolism after the surgery of laryn geal and hypopharyngeal carcinoma, and evaluate the diagnosis and prevention of such complication. Methods A ret rospective study was performed in 11 cases of postoperative pulmonary thromboembolism after laryngeal or hypopharyn geal carcinoma surgery. The symptoms, auxiliary examinations and treatment were analyzed. Results Among 453 la ryngeal carcinoma and 134 hypopharyngeal carcinoma patients who underwent the surgery , there were 11 cases of postoperative pulmonary thromboembolism （ 1.9% ）. Chest distress and breath-hold were the most common clinical mani festations. 8 cases were diagnosed by computed tomography pulmonary angiography, and 3 cases were diagnosed by ventilation-perfusion （V/Q） scintigraphy. All of the 11 cases received anticoagulant treatment. Conclusions The pul monary thromboembolism after laryngeal and hypopharyngeal carcinoma surgery is not rare. The preoperative evaluation and postoperative prevention are important.