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[大疱性表皮松解症患儿的麻醉]

[Anaesthesia for children with epidermolysis bullosa].

作者信息

Knab Jana, Schumann Hauke, Kaltofen Heike, Steinmann Daniel

机构信息

Anästhesiologischen Universitätsklinik Freiburg mit Tätigkeitsschwerpunkt Kinderanästhesie.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2010 Oct;45(10):618-24. doi: 10.1055/s-0030-1267526. Epub 2010 Oct 19.

Abstract

Epidermolysis bullosa (EB) is a heterogeneous group of inherited rare diseases, which are characterized by trauma-induced blister formation of the skin and mucosa. The underlying cause is a functional deficiency of structural proteins of the epidermis or the dermis. Depending on the level of the blister formation, EB is divided into EB simplex (intra-epidermal), junctional EB (within the lamina lucida), dystrophic EB (below the lamina lucida) and Kindler syndrome (variable level of split formation). Besides different distinct blister formation and pain symptoms secondary problems like anaemia, oesophageal stenosis, cardiomyopathy or squamous cell carcinoma may occur. Since causal therapies are not available strict prevention of friction and trauma is essential to avoid blister formation. Anaesthesia challenges exist in the field of bedding procedures, care of the skin, monitoring, airway management und analgesia. This article gives a review over the EB and highlights in detail the corresponding anaesthesia characteristics.

摘要

大疱性表皮松解症(EB)是一组遗传性罕见疾病,其特征为皮肤和黏膜因外伤而形成水疱。根本原因是表皮或真皮结构蛋白的功能缺陷。根据水疱形成的层面,EB分为单纯性EB(表皮内)、交界性EB(透明层内)、营养不良性EB(透明层以下)和Kindler综合征(分裂形成层面不定)。除了不同的明显水疱形成和疼痛症状外,还可能出现贫血、食管狭窄、心肌病或鳞状细胞癌等继发性问题。由于尚无因果疗法,严格预防摩擦和外伤对于避免水疱形成至关重要。在卧床护理、皮肤护理、监测、气道管理和镇痛等领域存在麻醉挑战。本文对EB进行了综述,并详细强调了相应的麻醉特点。

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