腹腔镜子宫切除术后高乳酸血症1例诊治分析
DOI:
https://doi.org/10.62177/fcdt.v1i4.776关键词:
腹腔镜, 子宫脱垂, 阴道脱垂, 高乳酸血症, 休克摘要
腹腔镜子宫切除术后高乳酸血症的发生较为少见，临床识别难度大，若不能及时识别和干预，可能迅速进展为多器官功能障碍甚至死亡。本文回顾性分析1例老年女性腹腔镜子宫切除术后出现进行性高乳酸血症的诊治经过，探讨其可能病因、诊断思路及处理策略，总结经验教训，以期为术后不明原因乳酸升高患者的临床识别与干预提供参考。
参考
Bazin JE, Gillart T, Rasson P, Conio N, Aigouy L, Schoeffler P. Haemodynamic conditions enhancing gas embolism after venous injury during laparoscopy: a study in pigs. Br J Anaesth. 1997;78(5):570-575
Pulmonary Embolism & Pulmonary Vascular Diseases Group of the Chinese Thoracic Society; Pulmonary Embolism & Pulmonary Vascular Disease Working Group of Chinese Association of Chest Physicians; National Cooperation Group on Prevention & Treatment of Pulmonary Embolism & Pulmonary Vascular Disease. Zhonghua Yi Xue Za Zhi. Published online June 27, 2025.
邓水珠,付丽明,林焕明,等.CO2气腹压力预设阈值设定方案构建对腹腔镜手术患者血流动力学及并发症的影响[J].齐齐哈尔医学院学报,2024,45(21):2063-2067.
Orhurhu VJ, Gao CC, Ku C. Carbon Dioxide Embolism. In: StatPearls. Treasure Island (FL): StatPearls Publishing; November 28, 2022.
Jayaraman S, Khakhar A, Yang H, Bainbridge D, Quan D. The association between central venous pressure, pneumoperitoneum, and venous carbon dioxide embolism in laparoscopic hepatectomy. Surg Endosc. 2009;23(10):2369-2373.
Muchada R, Rinaldi A, Stern P. Detección de microburbujas formadas en la interfase sangre/CO2 durante la descompresión en condiciones barométricas similares a las de la laparoscopia [Detection of microbubbles formed in the blood/CO2 interphase during decompression in barometric conditions similar to laparoscopy]. Rev Esp Anestesiol Reanim. 1996;43(9):314-317.
李小双,马茂森,查卫峰,等.腹腔镜子宫切除术合并高乳酸血症的影响因素分析[J].中外医疗,2024,43(27):34-36.DOI:10.16662/j.cnki.1674-0742.2024.27.034.
何丽.腹腔镜手术在妇科领域中的应用进展[J].微创医学,2022,17(03):354-358.
]蒋梦桃,严丽洁,孙珊.不同气腹压力对腹腔镜全子宫切除术患者术中低体温、应激反应和术后恢复的影响[J].川北医学院学报,2025,40(06):813-816.
Baddam S, Tubben RE. Lactic Acidosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 28, 2025.
DeFronzo R, Fleming GA, Chen K, Bicsak TA. Metformin-associated lactic acidosis: Current perspectives on causes and risk. Metabolism. 2016;65(2):20-29.
Suetrong B, Walley KR. Lactic Acidosis in Sepsis: It's Not All Anaerobic: Implications for Diagnosis and Management. Chest. 2016;149(1):252-261.
Bakker J, Postelnicu R, Mukherjee V. Lactate: Where Are We Now?. Crit Care Clin. 2020;36(1):115-124.
Çeleğen M, Çeleğen K. Lactate Clearance as an Early Prognostic Marker of Mortality for Pediatric Trauma. Laktatabbau als frühzeitiger prognostischer Marker für die Sterblichkeit bei pädiatrischen Traumat. Klin Padiatr. 2023;235(5):270-276.
Kim K, Lee DH, Lee DH, Choi YH, Bae SJ. Early lactate clearance for predicting outcomes in patients with gastrointestinal bleeding. Ir J Med Sci. 2023;192(4):1923-1929.
Sobolewski P, Kandel J, Eckmann DM. Air bubble contact with endothelial cells causes a calcium-independent loss in mitochondrial membrane potential. PLoS One. 2012;7(10):e47254. doi:10.1371/journal.pone.0047254
曹金花.妇科腹腔镜手术气腹、体位调整对呼吸与循环功能的影响[C]//中国防痨协会.中国防痨协会超声专业分会成立大会暨首届全国结核病超声医学学术会议论文集.安陆市普爱医院;,2025:133-137.DOI:10.26914/c.cnkihy.2025.017523.
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