BACKGROUND Pulmonary thromboembolism(PTE)is a serious postoperative complication that can occur after a fracture.Generally,PTE is caused by the falling off of lower extremity deep vein thrombosis(LEDVT)after lower lim...BACKGROUND Pulmonary thromboembolism(PTE)is a serious postoperative complication that can occur after a fracture.Generally,PTE is caused by the falling off of lower extremity deep vein thrombosis(LEDVT)after lower limb fracture surgery.LEDVT and PTE after upper extremity fracture surgery are very rare.PTE is one of the most common clinical causes of sudden death.Venous thromboembolism includes PTE and DVT.We experienced one case of LEDVT and PTE after distal ulna and radius fracture surgery.The purpose of our report is to raise awareness for orthopedic surgeons that PTE can occur after distal ulna and radius fracture surgery,and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.CASE SUMMARY We report a 51-year-old Chinese male who had severe fractures of the left distal ulna,radius and little finger after a motorcycle accident.The patient underwent external fixation,open reduction and internal fixation.On the third post-operative day,computed tomographic pulmonary angiography showed PTE.Doppler ultrasonography showed thrombus formation in the bilateral posterior tibial veins.After a period of anticoagulation therapy,on the 25th d after the PTE,computed tomographic pulmonary angiography showed that thrombus in both sides of the pulmonary artery disappeared.Furthermore,about 4 mo after the PTE,thrombosis in the deep veins of the lower limbs disappeared.About 1 year after the surgery,X-rays showed good fracture healing,and the function of the wrist joint recovered well.CONCLUSION Though rare,PTE can occur after distal ulna and radius fracture surgery and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.展开更多
目的探讨肋骨内固定联合机械通气对创伤性连枷胸合并肺挫伤患者呼吸功能及呼吸系统并发症的影响。方法选取2014年7月—2020年9月在该院接受治疗的创伤性连枷胸合并肺挫伤患者60例,依据治疗方案将患者分为研究组(n=45)及对照组(n=15)。...目的探讨肋骨内固定联合机械通气对创伤性连枷胸合并肺挫伤患者呼吸功能及呼吸系统并发症的影响。方法选取2014年7月—2020年9月在该院接受治疗的创伤性连枷胸合并肺挫伤患者60例,依据治疗方案将患者分为研究组(n=45)及对照组(n=15)。研究组患者采用肋骨内固定及机械通气治疗,对照组采用胸带外固定联合机械通气治疗,比较两组治疗前后血气分析指标、呼吸系统并发症。结果研究组患者机械通气及ICU治疗时间、总住院时间均相对于对照组缩短,差异有统计学意义(P<0.01)。从入院时至治疗后3 d两组患者PaO_(2)、SaO_(2)逐步升高,差异有统计学意义(P<0.01),研究组患者术后PaCO_(2)较前逐步降低,差异有统计学意义(P<0.01);手术治疗后1 d、3 d PaO_(2)、SaO_(2)均明显高于对照组,差异有统计学意义(P<0.01),治疗后3 d PaCO_(2)低于对照组,差异有统计学意义(P<0.01)。治疗后研究组呼吸系统相关并发症发生率15.6%低于对照组53.3%,差异有统计学意义(χ^(2)=6.667,P<0.05)。结论肋骨内固定联合机械通气可显著改善创伤性连枷胸合并肺挫伤患者呼吸功能,降低呼吸系统并发症,且缩短患者住院时间,安全可靠。展开更多
基金Shanghai Fengxian District Osteoarthropathy Clinical Diagnosis and Treatment Center,China,No.fxlczlzx-a-201704.
文摘BACKGROUND Pulmonary thromboembolism(PTE)is a serious postoperative complication that can occur after a fracture.Generally,PTE is caused by the falling off of lower extremity deep vein thrombosis(LEDVT)after lower limb fracture surgery.LEDVT and PTE after upper extremity fracture surgery are very rare.PTE is one of the most common clinical causes of sudden death.Venous thromboembolism includes PTE and DVT.We experienced one case of LEDVT and PTE after distal ulna and radius fracture surgery.The purpose of our report is to raise awareness for orthopedic surgeons that PTE can occur after distal ulna and radius fracture surgery,and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.CASE SUMMARY We report a 51-year-old Chinese male who had severe fractures of the left distal ulna,radius and little finger after a motorcycle accident.The patient underwent external fixation,open reduction and internal fixation.On the third post-operative day,computed tomographic pulmonary angiography showed PTE.Doppler ultrasonography showed thrombus formation in the bilateral posterior tibial veins.After a period of anticoagulation therapy,on the 25th d after the PTE,computed tomographic pulmonary angiography showed that thrombus in both sides of the pulmonary artery disappeared.Furthermore,about 4 mo after the PTE,thrombosis in the deep veins of the lower limbs disappeared.About 1 year after the surgery,X-rays showed good fracture healing,and the function of the wrist joint recovered well.CONCLUSION Though rare,PTE can occur after distal ulna and radius fracture surgery and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.
文摘目的探讨肋骨内固定联合机械通气对创伤性连枷胸合并肺挫伤患者呼吸功能及呼吸系统并发症的影响。方法选取2014年7月—2020年9月在该院接受治疗的创伤性连枷胸合并肺挫伤患者60例,依据治疗方案将患者分为研究组(n=45)及对照组(n=15)。研究组患者采用肋骨内固定及机械通气治疗,对照组采用胸带外固定联合机械通气治疗,比较两组治疗前后血气分析指标、呼吸系统并发症。结果研究组患者机械通气及ICU治疗时间、总住院时间均相对于对照组缩短,差异有统计学意义(P<0.01)。从入院时至治疗后3 d两组患者PaO_(2)、SaO_(2)逐步升高,差异有统计学意义(P<0.01),研究组患者术后PaCO_(2)较前逐步降低,差异有统计学意义(P<0.01);手术治疗后1 d、3 d PaO_(2)、SaO_(2)均明显高于对照组,差异有统计学意义(P<0.01),治疗后3 d PaCO_(2)低于对照组,差异有统计学意义(P<0.01)。治疗后研究组呼吸系统相关并发症发生率15.6%低于对照组53.3%,差异有统计学意义(χ^(2)=6.667,P<0.05)。结论肋骨内固定联合机械通气可显著改善创伤性连枷胸合并肺挫伤患者呼吸功能,降低呼吸系统并发症,且缩短患者住院时间,安全可靠。
