1例气管切开术后气管狭窄的处理。

Q3 Medicine Anesthesia progress Pub Date : 2021-12-01 DOI:10.2344/anpr-68-03-08
Kazumi Takaishi, Shinji Kawahito, Hiroshi Kitahata
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引用次数: 1

摘要

气管切开术后气管狭窄会引起气道管理困难和呼吸并发症。由于气管狭窄的症状只有在严重后才会出现,因此很难根据患者的症状来预测气管切开术后的气管狭窄。对于既往有气管切开术史的患者,重要的是要考虑气管狭窄的危险因素。术前对有气管切开术史的患者进行详细的评估是必要的,并应包括气道的三维评估。我们报告一名83岁妇女,因先前的紧急气管切开术而有气管狭窄的高风险,她因鳞状细胞癌而被安排接受全身麻醉进行右上颌切除术,术前评估和围手术期处理。术前胸部正位x光片显示气管狭窄。通过计算机断层成像和纤维支气管镜对狭窄区域进行了进一步的详细检查。全麻鼻气管插管,术中无不良事件发生,拔管后出现喘鸣。通过超声雾化器雾化肾上腺素,有效改善患者术后一过性呼吸困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Management of a Patient With Tracheal Stenosis After Previous Tracheotomy.

Tracheal stenosis after tracheotomy can cause difficult airway management and respiratory complications. It is difficult to predict tracheal stenosis after tracheotomy based on a patient's symptoms as the symptoms of tracheal stenosis appear only after they become severe. In patients with a history of previous tracheotomy, it is important to consider the risk factors for tracheal stenosis. Detailed preoperative evaluation of patients with a history of previous tracheotomy is essential and should include 3-dimensional assessment of the airway. We report the preoperative assessment and perioperative management of an 83-year-old woman at high risk for tracheal stenosis due to a previous emergency tracheotomy who was scheduled to undergo general anesthesia for a right maxillectomy for squamous cell carcinoma. Preoperative anteroposterior chest radiograph revealed findings indicative of tracheal stenosis. Additional detailed examinations of the stenotic area were conducted with computed tomography imaging and bronchofiberscopy. General anesthesia with nasotracheal intubation was performed, and although there were no adverse intraoperative events, stridor after extubation was observed. Nebulized epinephrine was administered via an ultrasound nebulizer and effectively improved the patient's postoperative transient dyspnea.

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来源期刊
Anesthesia progress
Anesthesia progress Medicine-Medicine (all)
CiteScore
0.90
自引率
0.00%
发文量
32
期刊介绍: Anesthesia Progress is a peer-reviewed journal and the official publication of the American Dental Society of Anesthesiology. The journal is dedicated to providing a better understanding of the advances being made in the art and science of pain and anxiety control in dentistry.
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