Unusual pulmonary embolism - Septic pulmonary embolism and amniotic fluid embolism
Unusual pulmonary embolism - Septic pulmonary embolism and amniotic fluid embolism
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DOI：
10.1253/circj.71.772
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发表时间：
2007-05-01
影响因子：
3.3
通讯作者：
Shirato, Kunio
中科院分区：
文献类型：
--
作者：
Sakuma, Masahito;Sugimura, Koichiro;Shirato, Kunio
背景败血症和羊水栓塞是肺栓塞（PE）的罕见来源，因此本研究试图阐明这些cases.Methods和结果的背景，共11,367例PE的情况下，从396,982尸检确定。脓毒性PE的发生率为247例（2.2%）。85.6%的病例能找到感染源。真菌栓子检出率高于细菌栓子。最常见的真菌是曲霉菌（20.8%）。与真菌栓子相关的原发病为白血病（43.2%）。与妊娠和/或分娩相关的PE病例的发生率为89例（0.8%）。其中阴道分娩的45例PE中羊水栓塞33例（73.3%），剖宫产的33例PE中羊水栓塞7例（21.2%）（P < 0.0001）。剖宫产病例发生PE的主要原因是血栓性栓塞，阴道分娩病例发生PE的主要原因是羊水栓塞。
Background Septic and amniotic fluid emboli are rare sources of pulmonary embolism (PE), so the present study sought to elucidate the background of these cases.Methods and Results A total of 11,367 PE cases were identified from 396,982 postmortem examinations. The incidence of septic PE was 247 (2.2%) of the total. The origin of infection was found in 85.6% of the cases. Fungal embolus was detected more often than bacterial embolus. The most frequently detected fungus was aspergillus (20.8%). The primary disease associated with fungal embolus was leukemia (43.2%). The incidence of PE cases associated with pregnancy and/or delivery was 89 (0.8%) of the total PE cases. Among them, amniotic fluid embolism was found in 33 (73.3%) of 45 PE cases with vaginal delivery, and in 7 (21.2%) of 33 PE cases with cesarean delivery (p < 0.0001).Conclusion Fungal embolus was more frequent than bacterial embolus, and leukemia was most frequent as the primary disease in cases of fungal embolus. The main cause of PE in cesarean section cases was thrombotic embolism, and the main cause in vaginal delivery cases was amniotic fluid embolism.