通过支气管镜对气管狭窄和面部及颈部严重疤痕挛缩患者进行气道管理:病例报告。

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-09-20 DOI:10.1186/s13019-024-03064-4
Yu Lu, Wenwen Zhang, Yong Zhang, Xiajuan Hu, Rukun Xu, Hongwei Shi, Xiaoliang Wang
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引用次数: 0

摘要

麻醉师和外科医生在处理面颈部气道狭窄和瘢痕挛缩时都会遇到困难。在此,我们报告了一名 38 岁女性(体重指数 23.1 kg/m2,全身 40% 三度烧伤,美国麻醉医师协会身体状况 III 级)气道狭窄的罕见病例。这名患者的气道困难是可以预见的(张口2厘米,双侧鼻孔疤痕增生,马兰帕蒂评分III级,头颈部疤痕,气管严重狭窄)。在声门下方 8 厘米处发现了宽度为 5.5 毫米的气管狭窄,支气管镜无法通过。在两次喉罩插入失败后,我们决定在纤维支气管镜的引导下插入特制的气管导管。手术很成功,病人被转入重症监护室(ICU)。
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Airway management for patients with tracheal stenosis and severe scar contracture of the face and neck via bronchoscopy: a case report.

Both anaesthesiologists and surgeons experience challenges in managing airway stenosis and scar contracture in the face and neck. Herein, we report the case of a 38-year-old woman (BMI 23.1 kg/m2, third-degree burns covering 40% of her body, an American Society of Anaesthesiologists physical status III) with an unusual case of airway constriction. This patient had a predictable difficult airway (mouth opening of 2 cm, bilateral nostril scar hyperplasia, Mallampatti score III, scarring of the head and neck, and severe tracheal stenosis). Tracheal stenosis measuring 5.5 mm in width as observed 8 cm below the glottis, and the bronchoscope could not pass through it. After two failed attempts at laryngeal mask insertion, we decided to instead insert a custom-made tracheal tube under the guidance of a fiberoptic bronchoscope. The operation was successful, and the patient was transferred to the intensive care unit (ICU).

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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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