在高风险的ASA类V患者中,在连续脊髓麻醉下进行清醒的sigmoidectomy:一个病例报告
Henry Abumohor1, Yara Taha2, Seham Madaka2
1Faculty of Medicine, Medical Research Club, Al-Quds University, Jerusalem, Palestine. henry.am822@gmail.com.
Patient safety in surgery
|December 20, 2025
概括
使用连续细分脊髓麻醉的清醒sigmoidectomy对于具有多种健康问题的高风险患者来说是可行的和安全的. 这种方法为全身麻醉提供了可行的替代方案,即使在资源有限的环境中也是如此.
科学领域:
- 麻醉学 麻醉学
- 结肠直肠手术 结肠直肠手术
- 区域麻醉地区麻醉
背景情况:
- 醒着结直肠手术提供了全身麻醉的替代方案,特别是在心肺问题高风险患者.
- 连续细分脊髓麻醉提供稳定的条件,避免诸如镇静和呼吸道操纵等风险.
- 这种技术在主要的结直肠手术中被低估.
研究的目的:
- 在连续细分脊髓麻醉下呈现一个清醒的开放性sigmoidectomy病例.
- 评估这种方法在高风险患者中的可行性和安全性.
主要方法:
- 一名73岁的男性患有ASA风险类V (缺血性心肌病,心力衰竭,CKD,肺部并发症) 经历了醒着的开放性sigmoidectomy.
- 使用连续细分脊髓麻醉,患者保持意识和稳定.
- 术后康复被监控并发症.
主要成果:
- 患者在整个清醒的西格莫切除术过程中保持完全清醒和血液动力学稳定.
- 恢复不复杂,只有表面的伤口感染被保守地管理.
- 在六个月的随访中,该患者无症状,伤口完全愈合,没有解门问题.
结论:
- 清醒时的西格莫切除术对于脆弱,多病症患者来说是可行的,也是安全的.
- 这一案例凸显了区域麻醉和多学科护理在高风险手术中的重要性.
- 这是巴勒斯坦首例报告的病例,显示了资源有限的地区的潜力.
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