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中华危重症医学杂志(电子版) ›› 2023, Vol. 16 ›› Issue (02) : 159 -161. doi: 10.3877/cma.j.issn.1674-6880.2023.02.013

病例报告

高压氧治疗CT引导下肺穿刺活检致脑空气栓塞一例
韩凯迪, 邹会达, 王立刚, 于清霞()   
  1. 264000 山东烟台,青岛大学附属烟台毓璜顶医院重症医学科
    264000 山东烟台,青岛大学附属烟台毓璜顶医院介入医学科
  • 收稿日期:2022-08-09 出版日期:2023-04-30
  • 通信作者: 于清霞
  • Received:2022-08-09 Published:2023-04-30
引用本文:

韩凯迪, 邹会达, 王立刚, 于清霞. 高压氧治疗CT引导下肺穿刺活检致脑空气栓塞一例[J]. 中华危重症医学杂志(电子版), 2023, 16(02): 159-161.

空气栓塞指因空气在短时间内进入血液循环形成气泡阻塞血管,根据气泡最终滞留位置的不同,可分为静脉空气栓塞和动脉空气栓塞。肺穿刺活检引发空气栓塞的诱因包括活检空洞性病变、血管炎性病变(如毛玻璃影)、咳嗽及正压通气等。本研究介绍了1例CT引导下肺穿刺活检发生空气栓塞导致脑梗死患者的诊疗过程,由此引发对空气栓塞病因、临床表现、影像学、诊断及治疗等方面的思考,以期增进临床医师对空气栓塞早期识别及诊疗的认识。

图1 CT引导下肺穿刺活检致脑空气栓塞患者胸部CT图注:患者肺穿刺活检2 h后胸部CT平扫肺窗,左心室可见气体(箭头)
图2 CT引导下肺穿刺活检致脑空气栓塞患者颅脑MRI图注:MRI.磁共振成像;DWI.扩散加权成像;a、b、c图分别为肺穿刺活检后当日颅脑MRI平扫DWI示左侧枕叶高信号、左侧颞叶高信号、右侧颞叶高信号(箭头),d、e、f图分别为治疗9 d后左侧枕叶高信号、左侧颞叶高信号、右侧颞叶高信号消失
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