Shamberger R C
Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Semin Pediatr Surg. 1999 May;8(2):61-8. doi: 10.1016/s1055-8586(99)70020-x.
Respiratory collapse is a well-recognized complication of general anesthesia in patients with an anterior mediastinal mass. Although numerous case reports document this occurrence, only recently have several series provided some guidance in defining which patients are at risk for respiratory collapse. Safe lower limits for two parameters at which general anesthesia can be used appear to be a tracheal area measured by computed tomography (CT scan), which is at least 50% of the area predicted for normals and peak expiratory flow rates, which are at least 50% of predicted. The problems with prebiopsy treatment are presented, and methods of obtaining diagnostic material by aspiration of a pleural effusion or performance of an anterior thoracotomy under local anesthesia are discussed.
呼吸衰竭是前纵隔肿物患者全身麻醉时一种公认的并发症。尽管有大量病例报告记录了这种情况，但直到最近才有几个系列研究为确定哪些患者有呼吸衰竭风险提供了一些指导。使用全身麻醉时两个参数的安全下限似乎是通过计算机断层扫描（CT扫描）测量的气管面积，该面积至少为正常预测面积的50%，以及呼气峰值流速，该流速至少为预测值的50%。文中介绍了活检前治疗存在的问题，并讨论了通过胸腔积液抽吸或在局部麻醉下进行前开胸手术获取诊断材料的方法。
