成功救治膝关节术中急性大面积肺栓塞1例

Successful treatment on a patient with acute massive pulmonary embolism in knee surgery

肺血栓栓塞症（pulmonary thromboembolism,PTE）是临床常见的急危重症,发病率高,临床漏诊、误诊率及病死率高;但如果能够在症状出现后短时间内得到明确诊断和及时治疗,其病死率会明显下降。根据＂美国心脏病学会（AHA）2011＂指南的意见,大面积或高危PTE的患者应接受溶栓治疗〔1〕,但由于在手术中发生PTE,有手术切口,溶栓治疗出血风险大,由于担心出血风险,不易立即做出溶栓决定；在手术中发生急性大面积肺栓塞，出现心率变慢、呼吸停止、血压低、血氧低等危重症，并给予患者进行溶栓治疗并取得成功病例报道不多。

Pulmonary embolism（PTE）is a common acute critical illness with high misdiagnosis rate and high mortality.Early diagnosis and thrombolytic therapy can save lives.Our department successfully rescued patients with pulmonary embolismin knee surgery.