Mounier-Kuhn 综合征患者全身麻醉期间的气道管理 - 病例报告。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-03-21 DOI:10.17085/apm.23172
Boreum Cheon, Ju Hyung Lee, Jae Hyung Kim, Sung Mi Hwang
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引用次数: 0

摘要

背景:穆尼埃-库恩综合征(MKS)是一种罕见的疾病,其特征是气管和主支气管异常扩张。MKS 在胸部 X 射线检查中很容易被漏诊,因此诊断非常困难。在全身麻醉的情况下,机械通气过程中出现的气道漏气或塌陷等问题可能会使获得足够潮气量的过程复杂化:一名 94 岁的妇女需要在全身麻醉下进行紧急髋关节半置换术。术前胸部 X 光检查显示气管和主支气管扩张,但患者没有呼吸道症状。我们诊断她患有 MKS,并选择了 8.0 毫米内径的加强型气管导管。我们将充气罩囊放置在声门下区域,一边充气一边监测是否漏气。在整个手术过程中,都保持了足够的潮气量:麻醉医生必须对 MKS 患者进行全面评估,包括复查胸片,并在手术前制定缜密的麻醉计划。
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Airway management of a patient with Mounier-Kuhn syndrome during general anesthesia - A case report.

Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by abnormal dilation of the trachea and main bronchi. MKS can be easily missed on chest X-rays, making diagnosis difficult. Under general anesthesia, challenges such as airway leakage or collapse during mechanical ventilation may complicate the achievement of adequate tidal volumes.

Cases: A 94-year-old woman requiring emergency hemiarthroplasty of the hip under general anesthesia was admitted. Preoperative chest X-rays revealed dilation of the trachea and main bronchi, but the patient exhibited no respiratory symptoms. We diagnosed her with MKS and opted for an 8.0-mm-inner-diameter reinforced tracheal tube. We positioned the cuff in the subglottic area, inflating it while monitoring for air leakage. Throughout the surgery, adequate tidal volume was maintained.

Conclusions: Anesthesiologists must conduct a comprehensive evaluation of patients with MKS, including a review of chest radiographs, and establish a meticulous anesthesia plan prior to surgery.

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