新冠肺炎合并肺栓塞的外科治疗:第一手经验

Sergey A. Fedorov, S. A. Zhurko, V. Pichugin, Vladimir A. Chiginev, Anton L. Maximov, Sanika V. Kulkarni
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引用次数: 0

摘要

导语:静脉血栓栓塞性并发症在2019冠状病毒病(COVID-19)相关并发症结构中占据中心位置之一。其特点是流行病学阈值高,临床表现不典型,因此需要采用新的方法进行早期诊断和积极治疗。肺栓塞的外科治疗本身就是一种极具争议的肺动脉床再灌注方法。关于与新型冠状病毒感染相关的肺栓塞,我们在现有文献中未发现一例临床病例报告。本文介绍了一例以COVID-19感染为背景的肺栓塞手术治疗的临床病例,展示了综合治疗方法,并描述了临床表现的特点。结论:根据本病例,我们应该注意到抗凝治疗在病毒特异性干预人群中预防血栓栓塞并发症复发的重要性。复杂的手术治疗结合麻醉支持方法是心脏性早期死亡中高、高风险人群的首选方法。
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Surgical Treatment of Pulmonary Embolism Associated with COVID-19: First-Hand Experience
INTRODUCTION: Venous thromboembolic complications occupy one of the central positions in the structure of complications associated with CoronaVirus Disease 2019 (COVID-19). Characterized by high epidemiological threshold values, as well as an atypical clinical picture, they determine the need for new approaches to early diagnosis and active treatment. Surgical treatment of pulmonary embolism in itself is an extremely controversial method of reperfusion of the pulmonary arterial bed. Concerning pulmonary embolism associated with a new coronavirus infection, we did not find a single clinical case reported in the available literature. The article considers a clinical case of surgical treatment of pulmonary embolism against the background COVID-19 infection, demonstrates a comprehensive approach to treatment and describes peculiarities of the clinical picture. CONCLUSION: Based on the presented case, one should note the importance of the anticoagulant therapy in a group of people with a virus-specific intervention to prevent recurrence of thromboembolic complications. Complex surgical treatment in combination with the proposed methods of anesthesiological support are the methods of choice in a group of people at intermediate-high and high risk of early cardiac death.
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