Kikutani Takehiko, Inagi Toshiichiroh, Sugimoto Kikuzoh, Shimada Yohichi
Department of Anesthesiology, Nippon Medical School 2nd Hospital, Kanagawa 211-8533.
Masui. 2002 Mar;51(3):274-6.
A 38-year-old female, at 38-week gestation, was scheduled for cesarean section under epidural anesthesia. After the delivery, it was found that she had been diagnosed as myotonic dystrophy by the other physician and the neonate was a floppy infant indicating hereditary neuromuscular diseases. In her case, myotonic dystrophy had not been advanced and symptoms had been mild. We previously had given her general anesthesia for two times with nitrous oxide, isoflurane and vecuronium for her to undergo emergency operations, left salpingectomy under laparoscopy due to unruptured tubal pregnancy at 34 years of age and cesarean section due to liver function disorder indicating HELLP syndrome at 36 years of age. Although many problems have been described about the perioperative management in patients with myotonic dystrophy, she was safely managed for each operation.
一名38岁女性，孕38周，计划在硬膜外麻醉下行剖宫产术。分娩后发现，她被其他医生诊断为强直性肌营养不良，新生儿为松软儿，提示遗传性神经肌肉疾病。在她的病例中，强直性肌营养不良尚未进展，症状较轻。我们之前曾两次为她实施全身麻醉，使用氧化亚氮、异氟烷和维库溴铵，以便她接受急诊手术，34岁时因输卵管妊娠未破裂行腹腔镜下左侧输卵管切除术，36岁时因肝功能障碍提示HELLP综合征行剖宫产术。尽管关于强直性肌营养不良患者围手术期管理已描述了许多问题，但她每次手术均得到了安全管理。
