[全身麻醉期间与哮喘发作相关的张力性气胸病例]

[Case of tension pneumothorax associated with asthma attack during general anesthesia].

作者信息

Komasawa Nobuyasu, Ueki Ryusuke, Kusuyama Kazuki, Okano Yukari, Tatara Tsuneo, Tashiro Chikara

机构信息

Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya 663-8501.

出版信息

Masui. 2010 May;59(5):614-7.

PMID:20486574

Abstract

We report a case of tension pneumothorax associated with asthma attack during general anesthesia. An 86-year-old woman with dementia underwent cataract surgery under general anesthesia. At 70 min after the start of operation, airway pressure suddenly increased from 19 to 28 cm HO2O. In spite of bag ventilation with 100% oxygen, Sp(O2) decreased to 81%. Chest-Xp showed typical image of tension pneumothorax. Chest drainage was immediately performed, after which Pa(O2) recovered soon. She was extubated on postoperative day 1 without any neurological disorder. Hyperinflation of fragile alveoli by mechanical ventilation was likely a cause of tension pneumothorax.

摘要

我们报告一例全身麻醉期间与哮喘发作相关的张力性气胸病例。一名86岁患有痴呆症的女性在全身麻醉下接受白内障手术。手术开始70分钟后，气道压力突然从19cmH₂O升至28cmH₂O。尽管给予100%氧气进行球囊通气，Sp(O₂)仍降至81%。胸部X线显示典型的张力性气胸影像。立即进行胸腔引流，之后Pa(O₂)很快恢复。她在术后第1天拔管，无任何神经功能障碍。机械通气导致脆弱肺泡过度充气可能是张力性气胸的一个原因。