宫颈癌全子宫切除术后发生毛细血管渗漏综合征 1例

目的探讨宫颈癌病人术后发生毛细血管渗漏综合征( capillary leakage syndrome，CLS)的病因、临床表现及处理措施，为临床医师提供可靠经验，提高此类疾病诊治水平。方法分析 1例 2022年 7月于潍坊医学院附属医院术前诊断为子宫颈原位癌而术后病理为浸润性宫颈癌的病人术后发生 CLS的过程及诊疗经过，结合相关文献报道，总结宫颈癌病人术后发生 CLS的机制及处理措施。结果病人术中生命体征平稳，手术结束恢复体位时出现血压下降，给予去甲肾上腺素升压，待血压升至 100/60 mmHg返回病房后陆续出现胸闷、憋气及双下肢中度水肿，行 CT检查提示大量胸腹腔积液，给予地塞米松、羟乙基淀粉、血浆及人血白蛋白改善毛细血管通透性，补充血容量，限制性补液并间断性给予利尿剂等处理，经过积极治疗后病人病情好转。结论针对宫颈癌术后的病人，医务人员需严密观察，对胸闷、憋气、双下肢水肿等症状提高警惕，首先排除是否出现 CLS，一旦确诊立即给予相应的处理。

Capillary leakage syndrome after hysterectomy in a patient with cervical cancer: a case report

Objective To provide reliable experience for clinicians and improve the level of diagnosis and treatment of this diseaseby discussing the etiology, clinical manifestations, and management measures of capillary leakage syndrome (CLS) in cervical cancerpatients after surgery.Methods The process and treatment of postoperative CLS in a patient from the Affiliated Hospital of WeifangMedical University with the preoperative diagnosis of cervical carcinoma in situ and postoperative pathology of invasive cervical carcinoma in July 2022 were analyzed. The mechanism and management measures of postoperative CLS in patients with cervical carcinomawere summarized by combining the relevant literature reports.Results The vital signs of the patient were stable during the operation,the blood pressure decreased when the position was restored at the end of the operation, and noradrenaline was given to boost bloodpressure. After the blood pressure returned to 100/60 mmHg, chest tightness, shortness of breath, and edema of both lower limbs occurred one after another. CT examination revealed a large number of pleural and peritoneal effusions. Dexamethasone, hydroxyethylstarch, plasma, and human serum albumin were given to improve capillary permeability, supplement blood volume, restrict fluid replacement, and intermittent administration of diuretics. The patient''s condition improved after active treatment.Conclusion For postoperative patients with cervical cancer, medical staff need to observe closely and be alert to symptoms such as chest tightness, breath-holding, and bilateral lower limb edema to first rule out the presence of CLS and give appropriate treatment as soon as it is confirmed.