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巨型甲状腺瘤的麻醉管理与心脏并发症引起气管压缩:一个病例报告
Haikun Zhang1, Jinxiang Yu1, Chengcheng Chen2
1School of Anesthesiology, Shandong Second Medical University, Weifang, 261053, Shandong, China.
Journal of medical case reports
|December 30, 2025
概括
在呼吸道受损和心脏问题患者中,管理巨型甲状腺瘤需要仔细的麻醉计划. 这一案例突显了通过多学科合作和特定的麻醉策略成功切除瘤.
科学领域:
- 麻醉学 麻醉学
- 心脏病学 心脏病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 巨型甲状腺瘤可能会由于气管压缩而导致严重的呼吸损害.
- 同时出现的心脏并发症,如心房隔膜缺陷,增加了手术管理的重大复杂性.
- 麻醉管理对于呼吸道受损和心脏病患者至关重要.
研究的目的:
- 描述一个患有巨型甲状腺瘤和心房隔膜缺陷的患者的麻醉管理.
- 强调复杂案件的多学科合作和应急规划的重要性.
- 为患有双重病理的患者提供关于安全的外科手术前期治疗方案的见解.
主要方法:
- 一名72岁的女性患有巨型甲状腺瘤和心房隔膜缺陷,在全身麻醉下进行了瘤切除.
- 关键策略包括醒着内内输管,雷米马佐拉姆/苏夫坦尼尔用于程序耐受性,以及为外科气管切除做好准备.
- 用sevoflurane,remifentanil,sufentanil和神经肌肉阻塞剂维持了麻醉.
主要成果:
- 成功实现了瘤切除,导致气管的完全解压.
- 在30天的随访期间,患者没有经历术后并发症.
- 麻醉和手术计划有效地管理了复杂的呼吸道和心脏状况.
结论:
- 精细的跨学科沟通对于呼吸道受损和心脏并发症患者的安全麻醉至关重要.
- 结构化的外科手术期间协议对于管理双重病理的患者至关重要.
- 这个案例为处理涉及巨型甲状腺瘤的类似复杂临床场景提供了宝贵的见解.
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