21岁的患者小林因罕见支气管Dieulafoy病突发致命大咯血，肺部畸形血管破裂导致血氧暴跌，危及生命[1]。深圳市第三人民医院重症医学科主任医师黄佳表示，该疾病发病隐匿、进展迅猛，常规止血手段收效甚微[1]。
面对这一突发危重症，医院多学科团队展开了紧急救治[1]。医疗团队先采用VV-ECMO体外膜肺氧合支持患者生命[1]，随后尝试进行放射介入支气管动脉栓塞治疗，但由于血管通道狭窄迂曲，导管无法抵达病灶，介入治疗最终失败[1]。患者单次出血量可达200毫升[1]。经过累计23次多学科会诊，来自12个科室的医疗团队制定了根治方案[1]。最终，医院实施胸腔镜右肺切除手术，彻底根除病灶[1]。患者于7月10日脱离ECMO，成功抢救并康复出院[1]。
A 21-year-old woman surnamed Lin suffered a life-threatening pulmonary hemorrhage caused by bronchial Dieulafoy disease, a rare congenital blood vessel malformation in the lungs, following a rafting incident [1]. The condition triggered catastrophic bleeding from abnormal blood vessels in her lungs, with individual bleeding episodes reaching up to 200 milliliters and causing her blood oxygen levels to plummet to critical levels [1].
Medical teams at Shenzhen Third People's Hospital mounted an intensive rescue effort involving 12 different departments and 23 multidisciplinary consultations [1]. Treatment began with VV-ECMO (veno-venous extracorporeal membrane oxygenation) support to sustain the patient's vital functions [1]. When an attempted interventional radiological procedure to block the bleeding vessels failed—due to tortuous and narrowed vascular pathways that prevented the catheter from reaching the lesion—surgeons performed an emergency thoracoscopic right lung removal to eliminate the underlying source of hemorrhage [1]. The patient was successfully weaned from ECMO support on July 10 and subsequently recovered and was discharged from the hospital [1].
According to Dr. Huang Jia, chief physician of the intensive care unit, this disease progresses rapidly and insidiously, with conventional hemostasis methods proving largely ineffective [1].
