国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (3): 267-270.doi: 10.12280/gjfckx.20241162

• 普通妇科疾病及相关研究: 病例报告 • 上一篇    下一篇

宫腔镜术中突发空气栓塞一例

周媛, 王真真, 操孟冬, 沈雪()   

  1. 441000 武汉科技大学医学院襄阳市第一人民医院研究生联合培养基地妇产科(周媛,操孟冬);湖北医药学院附属襄阳市第一人民医院妇产科(王真真,沈雪)
  • 收稿日期:2024-12-21 出版日期:2025-06-15 发布日期:2025-06-19
  • 通讯作者: 沈雪 E-mail:FKxy1025@163.com

A Case of Sudden Air Embolism during Hysteroscopy

ZHOU Yuan, WANG Zhen-zhen, CAO Meng-dong, SHEN Xue()   

  1. Department of Obstetrics and Gynecology, Postgraduate Union Training Base of Xiangyang No.1 People′s Hospital, School of Medicine, Wuhan University of Science and Technology, Xiangyang 441000, Hubei Province, China (ZHOU Yuan, CAO Meng-dong);Department of Obstetrics and Gynecology, Xiangyang No.1 People′s Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China (WANG Zhen-zhen, SHEN Xue)
  • Received:2024-12-21 Published:2025-06-15 Online:2025-06-19
  • Contact: SHEN Xue E-mail:FKxy1025@163.com

摘要:

宫腔镜检查是妇科疾病常用的诊疗手段,而空气栓塞是宫腔镜术中一种罕见的但极为严重的并发症,若未能及时诊断和处理,可能导致不可逆的严重后果。报告1例24岁患者,顺产40 d后因阴道间断出血及超声提示宫腔异常回声而住院接受宫腔镜检查。术中患者突发烦躁,血压、血氧饱和度、呼气末二氧化碳分压(partial pressure of end-tidal carbon dioxide,PetCO2)急剧下降,经紧急抢救,患者生命体征一度平稳并转重症医学病房(intensive care unit,ICU)进一步治疗,但因病情反复,家属最终选择放弃治疗。本病例提示,宫腔镜检查术中若出现烦躁、血压下降、血氧饱和度下降等情况,需高度警惕空气栓塞的可能。尤其是PetCO2下降伴随血压下降,并难以用低血容量解释时,可能是空气栓塞的早期预警信号。因此,早期预防和及时诊断对于改善预后至关重要。

关键词: 宫腔镜检查, 栓塞,空气, 手术中并发症, 血气分析, 病例报告

Abstract:

Hysteroscopy is a commonly used diagnosis and therapeutic method for gynecological diseases. Air embolism is a rare but extremely serious complication during hysteroscopy. If it is not diagnosed and treated in time, it may lead to irreversible and severe consequences. This paper reports a case of a 24-year-old patient. After 40 days of normal vaginal delivery, the patient was hospitalized for hysteroscopy due to intermittent vaginal bleeding and abnormal echoe in the uterine cavity indicated by ultrasound. During the operation, the patient suddenly became irritable, and her blood pressure, blood oxygen saturation, and partial pressure of end-tidal carbon dioxide (PetCO2) dropped sharply. After emergency rescue, the patient′s vital signs were temporarily stable and she was transferred to the intensive care unit (ICU) for further treatment. However, due to the recurrence of the condition, the family members finally chose to give up treatment. This case suggests that if symptoms such as irritability, decreased blood pressure, and decreased blood oxygen saturation occur during hysteroscopy, the possibility of air embolism should be highly suspected. Especially when the PetCO2 is accompanied by a decrease in blood pressure and cannot be explained by hypovolemia, it may be an early warning signal of air embolism. Therefore, early prevention and timely diagnosis are crucial for improving the prognosis.

Key words: Hysteroscopy, Embolism, air, Intraoperative complications, Blood gas analysis, Case reports