Clinical Analysis Of 8 Cases With Pulmonary Embolism Following Major Surgery Of Gastric Carcinoma

ObjectiveTo study the etiology, clinical manifestation, hazard assessment,diagnosis, treatment and precaution of pulmonary embolism following major surgery of gastric carcinoma.MethodsEight cases of pulmonary embolism following major surgery of gastric carcinoma were analyzed retrospectively.Result1 cases showed typical pulmonary embolism triad consisting of dyspnea, chest ache and hemoptysis.8 cases showed elevated level of D-dimer, which were higher than 1000ug/L with a positive rate of 100%.2 cases were diagnosed by ventilation-perfusion(quotient)ratio and pulmonary arteriography separately. The symptoms of 6 cases treated with thrombolysis and anticoagulation disappeared, blood gas analysis and ultrasonic cardiogram also showed no abnomality.2 cases encountered vast pulmonary infarction and died.ConclusionsPatients with gastric cancer have a high risk of pulmonary embolism of 0.16%(8/5000), thus should be especially noticed when admitted. CTPA is considered to be a fast way to detect the PE with great accuracy, while the D-dimer is considered to have high sensitivity but low specificity. Thrombolytic therapy is relatively contraindicated to fatal pulmonary embolism. Heart failure could be rapidly ameliorated by the treatment of thrombolysis plus anticoagulation, and it could be considered as the basic treatment of PE after gastric cancer surgery.