Hardy F, Ngwingtin L, Bazin C, Babinet P
Service d'Anesthésie, Hôpital Delafontaine, Saint-Denis.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(1):65-8.
Hereditary angioneurotic oedema (HANE) is an autosomal dominant disorder, relatively uncommon, in which patients experience recurrent bouts of oedema of the extremities, face and larynx. Attacks of HANE, sometimes fatal when involving the larynx may, among other causes, be triggered by the anesthetist's manipulation of the upper airway (tracheal intubation). HANE may affect women during their reproductive years and present serious problems in case of pregnancy. Labour can precipitate laryngeal oedema in case of general anesthesia with tracheal intubation indicated for a caesarean section or a forceps delivery, and/or perineal oedema after delivery. The authors describe a vaginal delivery in a patient with HANE that was accomplished under lumbar epidural anesthesia. No laryngeal or perineal attack was noted. This review article describes various treatments and discusses the features relevant and specific to pregnancy.
遗传性血管性水肿(HANE)是一种常染色体显性疾病,相对罕见,患者会反复出现四肢、面部和喉部水肿。HANE发作有时会累及喉部,可导致死亡,除其他原因外,还可能由麻醉师对上呼吸道的操作(气管插管)引发。HANE可能在女性生育期发病,怀孕时会出现严重问题。剖宫产或产钳助产时若行气管插管全身麻醉,分娩过程中可诱发喉部水肿,和/或产后出现会阴水肿。作者描述了1例在腰段硬膜外麻醉下成功分娩的HANE患者。未观察到喉部或会阴发作。这篇综述文章介绍了各种治疗方法,并讨论了与妊娠相关的特定特征。