Sezaryen ameliyatı sonrası pulmoner emboli
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Dosyalar
Tarih
2007
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Gebelik tromboembolik komplikasyonların arttığı fizyolojik bir süreçtir. Otuz sekiz haftalık gebeliği takiben yapılan elektif sezaryen ameliyatı sonrası üçüncü saatte solunum sıkıntısı ve taflipne gelişen 36 yaşındaki hasta, toraks tomografisi ile pulmoner emboli tanısı konarak yoğun bakım ünitesine alındı. Hastaya traneksamik asid infüzyonu başlandı. Ekokardiyografide septal paradoks hareket ve sağ atriyumda inferior duvara yapışık 4x1 cm çapında hiperekojen mobil kitle izlendi. Hastanın solunum sıkıntısında artış ve hemodinamisinde bozulma oluştuğu için trombolitik infüzyon tedavisi başlandı, ancak ameliyat yerinden ve vagenden aktif kanama başlaması üzerine infüzyon durduruldu. Eritrosit süspansiyonu, taze kan, trombosit süspansiyonu ve taze donmuş plazma ile kanama kontrol altına alındı. Ekokardiyografide sağ atriyumda belirlenen trombüsün erimiş olduğu görülerek hasta dördüncü gün kadın hastalıkları doğum servisine çıkarıldı.
Pregnancy is a physiologic state with an increased risk for thromboembolic complications. Tachypnea and respiratory distress was evident in a 36- year old female patient in the postoperative third hour after an elective cesarean section in the 38. week of pregnancy. Thoracic tomography revealed pulmonary embolism, the patient was admitted to the intensive care unit and tranecsamic acid infusion was started. Paradoxical septal motion and a 4x1 cm hpyerechogenic mobile mass on the right atrium attached to the inferior wall was apparent in the echocardiographic assessment. Thrombolytic infusion therapy was started due to the worsening of the patient's respiratory distress and hemodynamic state but was withdrawn due to the active bleeding from the vagina and the operation site. Bleeding was controlled by erythrocyte and thrombocyte suspensions, freshly drawn blood, and fresh frozen plasma. Echocardiographic control revealed lysis of the thrombus in the right atrium and the patient was moved to the obstetrics ward on the 4. day.
Pregnancy is a physiologic state with an increased risk for thromboembolic complications. Tachypnea and respiratory distress was evident in a 36- year old female patient in the postoperative third hour after an elective cesarean section in the 38. week of pregnancy. Thoracic tomography revealed pulmonary embolism, the patient was admitted to the intensive care unit and tranecsamic acid infusion was started. Paradoxical septal motion and a 4x1 cm hpyerechogenic mobile mass on the right atrium attached to the inferior wall was apparent in the echocardiographic assessment. Thrombolytic infusion therapy was started due to the worsening of the patient's respiratory distress and hemodynamic state but was withdrawn due to the active bleeding from the vagina and the operation site. Bleeding was controlled by erythrocyte and thrombocyte suspensions, freshly drawn blood, and fresh frozen plasma. Echocardiographic control revealed lysis of the thrombus in the right atrium and the patient was moved to the obstetrics ward on the 4. day.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Trakya Üniversitesi Tıp Fakültesi Dergisi
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Scopus Q Değeri
Cilt
24
Sayı
2
