Blázquez E, Laguillo J L, Ariza M A, Avilez T S, López-Millán J M
Servicio de Anestesiología, Hospital Universitario Virgen Macarena, Sevilla, España.
Rev Esp Anestesiol Reanim. 2013 Dec;60(10):589-93. doi: 10.1016/j.redar.2012.10.001. Epub 2012 Dec 20.
Esophageal atresia is a rare condition (1:2,500-4,500), incompatible with life, and a surgical emergency in the neonatal period. It is associated with prematurity in 30% of cases, and to congenital abnormalities in 50% of cases, especially cardiac anomalies. Major congenital heart diseases and low weight are independent predictors of mortality and critical perioperative events. The aim of this article is to describe the most significant anaesthetic challenges presented in a case of a term neonate undergoing emergency surgery after being diagnosed with esophageal atresia, tracheoesophageal fistula type iiib/C, and imperforate anus. The major priorities during the anaesthetic management consist of establishing a safe airway and effective pulmonary ventilation that minimises air leakage to the upper digestive tract.
食管闭锁是一种罕见疾病(发病率为1:2500 - 4500),是一种危及生命的疾病,也是新生儿期的外科急症。30%的病例与早产有关,50%的病例与先天性异常有关,尤其是心脏异常。主要的先天性心脏病和低体重是死亡率和围手术期严重事件的独立预测因素。本文旨在描述一名足月新生儿在被诊断为食管闭锁、Ⅲb/C型气管食管瘘和肛门闭锁后接受急诊手术时所面临的最重大麻醉挑战。麻醉管理的主要优先事项包括建立安全气道和有效的肺通气,以尽量减少空气漏入上消化道。