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[一名患有唾液酸贮积症男孩的麻醉管理]

[Anesthetic management of a boy with sialidosis].

作者信息

González González G, Jiménez López I

机构信息

Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de Traumatología y Rehabilitaci6n. Hospitales Universitarios Virgen del Rocío, Sevilla.

出版信息

Rev Esp Anestesiol Reanim. 2006 Apr;53(4):253-6.

Abstract

Sialidosis is an autosomal recessive disease caused by neuraminidase deficiency, which causes material rich in sialic acid to accumulate in various tissues and organs, leading to morphological and functional changes. Mainly the osteoarticular, cardiorespiratory, and central nervous systems are affected. We report the case of a 14-year-old boy diagnosed with sialidosis type 2 who was proposed for spinal column arthrodesis to treat severe thoracolumbar scoliosis. Physical examination revealed pectus carinatum; facial deformity and macroglossia; hypertelorism and frontal bossing; short neck; atlantoaxial subluxation; severe arthrogryposis of elbows, knees and wrists, coxa valga, and club foot. Relevant medical history included moderately severe aortic valve insufficiency and myoclonic epilepsy. Surgery was performed under balanced anesthesia. Awakening was delayed and the patient was transferred to the intensive care unit under mechanical ventilation. Anesthetic problems that can present in patients with such deformities include difficult airway, complicated management of associated cardiopathy, and difficult weaning from mechanical ventilation.

摘要

唾液酸沉积症是一种由神经氨酸酶缺乏引起的常染色体隐性疾病,该酶缺乏会导致富含唾液酸的物质在各种组织和器官中蓄积,进而引发形态和功能改变。主要受累的是骨关节、心肺及中枢神经系统。我们报告一例14岁诊断为2型唾液酸沉积症的男孩病例,该患者因严重胸腰椎脊柱侧弯拟行脊柱融合术。体格检查发现鸡胸;面部畸形及巨舌;眼距过宽及额部隆突;短颈;寰枢椎半脱位;肘、膝及腕关节严重挛缩,髋外翻及马蹄足。相关病史包括中度严重主动脉瓣关闭不全及肌阵挛性癫痫。手术在平衡麻醉下进行。苏醒延迟,患者在机械通气支持下转入重症监护病房。此类畸形患者可能出现的麻醉问题包括气道困难、合并心脏病的复杂管理以及机械通气撤机困难。

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