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[麻醉诱导期间荧光素吸入：脑脊液瘘手术治疗前的并发症]

[Fluorescein aspiration during induction of anaesthesia : complication preceding surgical treatment of cerebrospinal fluid fistula].

作者信息

Olotu C, Münscher A, Schmidt G N

机构信息

Klinik und Poliklinik für Anästhesiologie, Zentrum für Anästhesiologie und Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.

出版信息

Anaesthesist. 2011 Aug;60(8):740-2. doi: 10.1007/s00101-011-1894-z. Epub 2011 Jul 6.

DOI:10.1007/s00101-011-1894-z
PMID:21728050
Abstract

This case history deals with an 85-year-old patient who underwent surgery to treat rhinoliquorrhea. The patient aspirated a lutescent fluid shortly after anesthesia was administered. However, this fluid was not gastric juice but cerebrospinal fluid (CSF) running down the nasopharynx. The CSF had been stained with fluorescein prior to surgery in order to help localize the CSF fistula. This case of top down aspiration is discussed and preventive measures which can be employed in order to avoid similar complications in patients with rhinoliquorrhea are presented.

摘要

本病例报告涉及一名85岁接受手术治疗鼻漏的患者。患者在麻醉给药后不久吸入了一种淡黄色液体。然而，这种液体并非胃液，而是经鼻咽部流下的脑脊液（CSF）。术前脑脊液已用荧光素染色，以帮助定位脑脊液瘘。本文讨论了这种自上而下的误吸情况，并提出了可用于避免鼻漏患者发生类似并发症的预防措施。

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Anaesthesist. 2011 Aug;60(8):740-2. doi: 10.1007/s00101-011-1894-z. Epub 2011 Jul 6.
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本文引用的文献

1
The utility of intrathecal fluorescein in cerebrospinal fluid leak repair.鞘内荧光素在脑脊液漏修复中的应用。
Otolaryngol Head Neck Surg. 2010 Nov;143(5):626-32. doi: 10.1016/j.otohns.2010.07.011.
2
The use of topical intranasal fluorescein in endoscopic endonasal repair of cerebrospinal fluid rhinorrhea.局部鼻内应用荧光素在内镜下经鼻脑脊液鼻漏修补术中的应用。
Surg Neurol. 2009 Oct;72(4):341-5; discussion 346. doi: 10.1016/j.surneu.2009.03.034. Epub 2009 Jul 15.
3
Supratentorial cerebrospinal fluid production rate in healthy adults: quantification with two-dimensional cine phase-contrast MR imaging with high temporal and spatial resolution.
Radiology. 2004 Nov;233(2):603-8. doi: 10.1148/radiol.2332030884.
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Use of sodium fluorescein solution for detection of cerebrospinal fluid fistulas: an analysis of 420 administrations and reported complications in Europe and the United States.
Laryngoscope. 2004 Feb;114(2):266-72. doi: 10.1097/00005537-200402000-00016.
5
Method for the identification and localization of cerebrospinal fluid, rhinorrhea and otorrhea.脑脊液、鼻漏和耳漏的识别与定位方法。
Laryngoscope. 1960 Jul;70:921-31. doi: 10.1288/00005537-196007000-00004.
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[Diagnosis of cerebrospinal fluid leakage at the base of the skull].
Schweiz Med Wochenschr. 2000 Nov 11;130(45):1715-25.
7
Identification of intranasal cerebrospinal fluid leaks by topical application with fluorescein dye.通过局部应用荧光素染料识别鼻内脑脊液漏。
Am J Rhinol. 2000 Mar-Apr;14(2):93-6. doi: 10.2500/105065800781692859.
8
[Surgical occlusion of cerebrospinal fistulas of the anterior skull base using intrathecal sodium fluorescein].[使用鞘内注射荧光素钠对前颅底脑脊液瘘进行手术封堵]
Laryngorhinootologie. 1997 Oct;76(10):595-607. doi: 10.1055/s-2007-997487.
9
[Endoscopic detection of cerebrospinal fluid fistulas with a fluorescence technique. Report of experiences with over 925 cases].[荧光技术在内镜下检测脑脊液瘘。925余例经验报告]
Laryngorhinootologie. 1997 Oct;76(10):588-94. doi: 10.1055/s-2007-997486.