神经外科患者并发急性肺栓塞的诊治分析

Analysis on diagnosis and treatment of neurosurgical patients with pulmonary embolism

目的探讨神经外科患者发生肺栓塞(PE)的高危因素及诊治方案。方法回顾性分析2019年5月—2020年4月南京医科大学附属苏州科技城医院神经外科收治的4例合并PE患者的临床资料,占同期重危患者的2.12%(4/189),并结合相关文献进行复习。结果4例中,三叉神经痛、脑膜瘤和脑出血手术后各1例,非手术重型颅脑损伤1例。首发PE距术后或伤后时间平均9.75 d,4例患者均采用国际通用预测肺栓塞风险量表评估,应用抗凝药物后均治愈。结论基于简洁、高效评分的分层管理模式,能够提升肺栓塞患者的早期识别,提高抢救成功率并改善预后。

Objective To discuss the high risk factors and diagnosis and treatment of neurosurgical patients with pulmonary embolism(PE).Methods The clinical data of 4 patients with PE admitted by the Department of Neurosurgery,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University from May 2019 to April 2020 were analyzed retrospectively,accounting for 2.12%(4/189)of the critically ill patients in the same period,and the related literature were reviewed.Results Among the 4 cases,1 was trigeminal neuralgia,1 was meningioma and 1 was cerebral hemorrhage after operation,and 1 was non operative severe brain injury.The average time from the first PE to the operation or injury was 9.75 days.All 4 patients were evaluated with the international general predictive PE risk scale.All patients were cured after the use of anticoagulants.Conclusion Hierarchical management based on concise and efficient prediction scores will promote early recognition ability,enhance rate of success of treatment and improve prognosis.