通过胸腔外科手术的末端气管切除来进行单肺通风:一个案例报告
Bridget Ng1, Suhitharan Thangavelautham1, Maria Aman1
1Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, SGP.
Cureus
|February 17, 2025
概括
在末端气管切除术患者中实现单肺通风 (OLV) 是一个挑战. 通过气管切除管放置的支气管阻塞剂 (BB) 在胸部手术期间成功隔离了肺部.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 标准的双管 (DLT) 往往不适合于一个肺通风 (OLV) 患者的末端气管切除.
- 全喉切除术后的解剖学变化,如气管缩短和非典型的静脉角,复杂化了OLV.
- 末端气管切除术患者需要量身定制的方法,以便在胸部手术期间安全有效地隔离肺部.
研究的目的:
- 描述一项成功的方法,以在接受视频辅助胸部手术 (VATS) 的终端气管切除术患者中实现OLV.
- 突出支气管阻断剂 (BBs) 在管理复杂的呼吸道解剖学中用于肺部隔离的有用性.
- 强调个性化OLV策略在气管切除术患者的重要性.
主要方法:
- 一个病例报告,一名68岁的男性患有末端气管切除术,正在接受VATS进行肺切除.
- 使用了7.5号Portex袖口式气管切除管,并配备了内Coopdech支气管阻塞剂 (BB) 来隔离肺部.
- 通过临床 (听觉) 和光纤支气管镜检查确认了肺部的隔离.
主要成果:
- 通过气管切除管和支气管阻塞剂,成功地实现了单肺通风.
- 支气管阻塞剂适应了患者异常的呼吸道解剖学,并最大限度地减少了口腔创伤.
- 在视频辅助胸部手术过程中,肺部隔离保持稳定.
结论:
- 支气管阻塞剂为终端气管切除术患者提供了OLV的DLT灵活有效的替代品.
- 这种方法成功地管理了肺部隔离,尽管存在解剖学上的挑战.
- 根据个体患者解剖学量身定制OLV策略对于优化终端气管切除术患者的治疗结果至关重要.
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