Chiu C L, Teh B T, Wang C Y
Department of Anaesthesia, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Br J Anaesth. 2003 Nov;91(5):742-4. doi: 10.1093/bja/aeg244.
A 27-yr-old lady with a past history of prolonged ventilation presented with worsening respiratory distress caused by tracheal stenosis. She required urgent tracheal resection and reconstruction. Because of the risk of an acute respiratory obstruction, spinal anaesthesia was used to establish cardiopulmonary bypass by cannulating the femoral artery and femoral vein. Adequate gas exchange was possible with full flow rate. Thoracotomy was then carried out to mobilize the left main bronchus. After successfully securing an airway by intubation of the left main bronchus, cardiopulmonary bypass was discontinued and tracheal resection and anastomosis was done under conventional one lung anaesthesia.
一位有长期机械通气病史的27岁女性因气管狭窄导致呼吸窘迫加重前来就诊。她需要紧急进行气管切除和重建手术。由于存在急性呼吸道梗阻的风险，采用脊髓麻醉，通过股动脉和股静脉插管建立体外循环。以全流量可实现充分的气体交换。然后进行开胸手术以游离左主支气管。在成功通过左主支气管插管确保气道安全后，停止体外循环，并在传统的单肺麻醉下进行气管切除和吻合术。
