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  • Title: [Thrombosis after establishing internal jugular vein channel in one burn patient].
    Author: Meng YL, Sun LP, Zhou YH, Jing C, Wang Q, Li DR.
    Journal: Zhonghua Shao Shang Za Zhi; 2019 May 20; 35(5):395-397. PubMed ID: 31154741.
    Abstract:
    On September 7th, 2017, one female patient, aged 48 years with deep partial-thickness flame burn on face, upper limbs, trunk, and lower limbs of 40% total body surface area was admitted to the First People's Hospital of Foshan City. After admission, active fluid replacement, anti-infection, nutritional support, and other treatments were performed. After debridement and skin grafting for 3 times and blood transfusion for 2 times, the patient recovered well. On the 20th day post admission, sudden heartbeat and respiratory arrest happened, and the patient died after ineffective rescue. Autopsy showed that thrombus formed in right internal jugular vein and deep veins of lower extremities, and vascular lumina of the bilateral pulmonary artery. The direct cause of death was acute pulmonary thromboembolism, but whether the embolus originated from deep vein of lower extremity or right internal jugular vein was not clear. This case suggests that clinician should not only pay attention to the prevention of deep venous thrombosis of lower extremities of burn patients, but also the possibility of internal jugular vein thrombosis, especially for patients with internal jugular vein access. 患者女，48岁，2017年9月7日因面部、双上肢、躯干、双下肢火焰烧伤收入佛山市第一人民医院，烧伤总面积40%体表总面积，烧伤深度均为深Ⅱ度。入院后给予积极补液、抗感染、营养支持等治疗，行3次清创植皮手术和2次输血后恢复良好。入院后第20天患者突发心跳、呼吸骤停，经抢救无效死亡。尸体检验见其右侧颈内静脉、双下肢深静脉及双肺肺动脉分支血管腔内血栓形成，直接死亡原因为急性肺动脉血栓栓塞，但栓子究竟是来源于下肢深静脉还是右侧颈内静脉未能明确。该病例提示临床医师不仅要注意防范烧伤患者下肢深静脉血栓形成，还要注意其颈内静脉血栓形成的可能性，尤其是建立颈内静脉通道的患者。.
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