术后的腹膜后血肿高展.pptVIP

Retroperitoneal Hematoma after PCI(PCI术后的腹膜后血肿) 阜外医院 高展 2008-6 Case 1 What is wrong with this case? Why not CABG for this LM+three vessel disease Why transfemoral: LM PCI Why not complete revascularization? Baseline characteristics 73 yrs, male Stable agina pecteris for over 10 years Essential hypertension intermittent claudication What happened during PCI procedure? 因挠动脉迂曲导致挠动脉入径失败 进入股动脉穿刺成功后，鞘管无法进入髂动脉 重新穿刺，泥鳅导丝进入腹主动脉，用长鞘成功 介入过程中，患者血压下降，面色苍白，打哈欠 经推注多巴胺，维持600ug/min静滴，血压维持，但患者腰痛，刺激性排便，呕吐 What happened after PCI procedure? 多巴胺800ug/min，患者从导管室转运到CCU 建立中心静脉通道 急查血常规：Hg：12g（术前13g） 快速补液，床旁超声：心包无异常