Maruta Toyoaki, Tateishi Machiko, Fujie Yasuyuki, Maruta Nozomi, Yamauchi Koichiro, Yano Takao, Kawano Taro, Tsuneyoshi Isao
Department of Anesthesiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka 882-0835.
Masui. 2011 Jul;60(7):862-5.
We experienced anesthesia and perioperative management for hysterectomy in a patient with acquired angioedema. Angioedema due to C1 esterase inhibitor (C1-INH) deficiency (loss or dysfunction of C1-INH) is one of the rarest diseases, and is characterized by recurrent episodes of regional hard edema and ascites induced by mechanical stimuli or mental stress. Edema spreads to the subcutaneous and submucosal layer, and laryngeal edema may cause the upper airway obstruction. Tranexamic acid and C1-INH concentrates were administered perioperatively for prophylaxis of attacks, and combined spinal and epidural anesthesia was performed for hysterectomy. We could manage perioperative care without causing edema.
我们对一名获得性血管性水肿患者进行了子宫切除术的麻醉和围手术期管理。由于C1酯酶抑制剂（C1-INH）缺乏（C1-INH丢失或功能障碍）导致的血管性水肿是最罕见的疾病之一，其特征是由机械刺激或精神压力诱发的局部硬性水肿和腹水反复发作。水肿蔓延至皮下和黏膜下层，喉头水肿可能导致上呼吸道梗阻。围手术期给予氨甲环酸和C1-INH浓缩物以预防发作，并对子宫切除术采用腰麻联合硬膜外麻醉。我们能够在不引起水肿的情况下进行围手术期护理。
