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一个患有气管支气管巨症的患者的呼吸道管理,正在接受叶切除术:一个病例报告
Sai-Nan Wang1, An-Shi Wu1, Jin-Bai Miao2
1Department of Anesthesiology, Beijing Chao-yang Hospital, Capital Medical University, Gongtinanlu 8#, Chaoyang, Beijing, 10020, China.
BMC anesthesiology
|November 3, 2023
概括
气管支气管巨症在胸部外科手术中提出了呼吸道管理方面的挑战. 使用喉膜口罩呼吸道和改造的双光线福利导管 (DFC) 的新技术,成功地在患有这种罕见疾病的患者中实现了单肺通风.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 肺部病理学 肺部病理学
背景情况:
- 气管和支气管扩张 (TBM) 是一种罕见的疾病,导致气管和支气管扩张和马拉西亚.
- 在TBM患者的呼吸道管理中,特别是需要单肺通风的胸部手术中,存在重大挑战.
- 传统的方法,如双光管,可能不适合TBM中扭曲的解剖学.
研究的目的:
- 描述一种新的方法,以实现一肺通风,在一个患有气管支气管大病的患者.
- 为了评估喉口罩气道与修改的双光线福利导管 (DFC) 结合用于肺隔离的疗效.
主要方法:
- 研究了一名64岁的TBM男性患者,他接受了左下叶切除术.
- 插入了4号喉膜呼吸道,并使用光纤支气管镜引导修改后的DFC进入左侧主要支气管.
- 为了实现肺部隔离,DFC气球被膨胀.
主要成果:
- 通过喉膜口罩呼吸道和修改的DFC成功实现了肺部隔离,没有显著的空气泄漏.
- 观察到非依赖性肺部的延迟崩,并通过低压人工肺胸术进行管理.
- 胸部手术成功完成,患者在术后被抽管.
结论:
- 带有修改的DFC的喉膜呼吸道可以作为一个有效的替代方案,以隔离肺在患者的气管支气管巨血病.
- 该技术为接受胸部手术的TBM患者的复杂气道管理提供了可行的解决方案.
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