头颈肿瘤术后并发急性肺栓塞2例

Two cases of acute pulmonary embolism in head and neck tumor surgery

1病例资料例1,男,66岁。因下咽癌侵及喉、食道上段并双颈淋巴结转移于2013年10月收入院。既往无心肺疾病史,术前心电图、肺功能及各项血液检查均正常。于全身麻醉下行全下咽、全喉及食上段切除术、游离空肠、下咽、食管吻合术及双颈部淋巴结清扫术。术后第6天患者突然出现胸痛、明显呼吸困难,神智清,血氧饱和度90%。查气道通畅,无痰块及异物堵塞。

A male patient with hypopharyngeal cancer accepted operation under general anesthesia.Sixth day after surgery in patient with sudden chest pain and obvious difficulty in breathing.Blood oxygen saturation of90%.The electrocardiogram showed:ST-T change,Tv6flat;blood gas analysis:pH 7.491,PCO234.1mmHg,PO254.7mmHg;D-Dimer 3.87mg/L;white blood cell 17.50×109/L.CTPA showed:right pulmonary artery embolism,pulmonary infection.Another male patient with the right tonsil cancer accepted operation under general anesthesia.Fourth day of patient suddenly appear bosom frowsty and obvious difficulty in breathing.Blood oxygen saturation of 88%.Blood gas analysis:pH:7.48,PCO2:33mmHg,,PO2:57mmHg;D-Dimer:2.97mg/L;white blood cell:11.80×109/L.CTPA showed:the main pulmonary artery and right pulmonary artery branch embolism,pulmonary inflammation.Both were diagnosised as acute pulmonary embolism and recovered well after giving anticoagulant therapy in time.