一例可能患有肥大细胞活化综合征的患者行肺栓塞切除术的成功治疗。

Ellen W. Richter, K. Hsu, Vanessa Moll
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引用次数: 3

摘要

我们报告一个成功的围手术期管理的病人假定肥大细胞增多症接受肺栓塞切除术。术后患者进入血管扩张性休克,部分原因是肥大细胞介质释放。给予H1和h2拮抗剂、类固醇和单剂量亚甲基蓝,血流动力学得到改善。患者于术后第2天停用血管活性物质并拔管。我们讨论肥大细胞增多症患者的围手术期处理,简要回顾有关心脏手术患者的麻醉处理的文献,并讨论本患者特发性肥大细胞激活综合征的替代但相关的诊断。
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Successful Management of a Patient With Possible Mast Cell Activation Syndrome Undergoing Pulmonary Embolectomy: A Case Report.
We report the successful perioperative management of a patient with presumed mastocytosis undergoing pulmonary embolectomy. Postoperatively the patient went into vasodilatory shock, which was partly attributed to mast cell mediator release. H1- and H2-antagonists, steroids, and a single dose of methylene blue were given with improvement of hemodynamics. The patient was weaned off vasoactive substances and extubated by postoperative day 2. We discuss the perioperative management of patients with mastocytosis, briefly review the literature concerning anesthetic management for cardiac surgery in patients with this disorder, and discuss our patient's alternative but related diagnosis of idiopathic mast cell activation syndrome.
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