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成人气管血管瘤患者的麻醉:肺叶切除术的单肺通气。

Anesthesia in an adult patient with tracheal hemangiomas: one-lung ventilation for lung lobectomy.

机构信息

Department of Anesthesiology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojimaku, Osaka 534-0021, Japan.

出版信息

J Anesth. 2012 Apr;26(2):269-72. doi: 10.1007/s00540-011-1289-y. Epub 2011 Nov 25.

Abstract

Primary tracheal tumors are rare in adults, and careful airway management is required during anesthesia for affected patients. We report the case of a patient with tracheal hemangiomas undergoing nontracheal operation. A 61-year-old woman was scheduled for a lung operation. During preoperative examination, hemangiomas were detected on the tracheal mucosa. As she was asymptomatic and the degree of airway stenosis was small, treatment was not required for the hemangiomas, and left upper lobectomy for lung cancer was scheduled. After induction of general anesthesia, a regular tracheal tube was inserted under fiberoptic bronchoscopy, with care taken to prevent damage to the hemangiomas. An endobronchial blocker was inserted for one-lung ventilation. The operation was performed uneventfully, and the tracheal tube was replaced postoperatively with a laryngeal mask airway while the patient was under deep anesthesia and neuromuscular blockade. The mask was removed after confirming lack of bleeding from the hemangiomas. No hypoxia or other complications occurred during or after the operation.

摘要

原发性气管肿瘤在成人中较为罕见,因此麻醉时需要对患者的气道进行仔细管理。我们报告了一例患有气管血管瘤的患者,她需要进行非气管手术。一名 61 岁女性拟行肺手术。术前检查时,发现气管黏膜有血管瘤。由于她无症状且气道狭窄程度较小,因此不需要对血管瘤进行治疗,计划行肺癌左上肺叶切除术。全身麻醉诱导后,在纤维支气管镜下插入常规气管导管,注意防止血管瘤受损。插入支气管内阻塞器以进行单肺通气。手术过程顺利,在患者深麻醉和神经肌肉阻滞下,用喉罩气道替代气管导管。在确认血管瘤无出血后,将其移除。手术过程中和手术后均未出现缺氧或其他并发症。

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