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[在右美托咪定和喉上神经阻滞下使用Air-Q气管插管喉罩成功管理因甲状腺癌侵犯导致的严重气管狭窄的气道]

[Successful Airway Management Using the air-Q Intubating Laryngeal Airway under Dexmedetomidine and Laryngeus Superior Nerve Block for Severe Tracheal Stenosis due to Thyroid Cancer Invasion].

作者信息

Nagamine Tatsunari, Komasawa Nobuyasu, Fujiwara Shunsuke, Nakao Kenta, Minami Toshiaki

出版信息

Masui. 2015 May;64(5):543-5.

Abstract

A 75-year-old woman suffering from respiratory difficulty was diagnosed with severe tracheal stenosis due o malignant thyroid cancer. She was scheduled for an mergent tracheotomy, but preoperative computed omography revealed severe tracheal stenosis below he glottis due to thyroid cancer invasion. Anticipating lifficult tracheal intubation and risk of obstruction from hemorrhage, intubation preserving spontaneous ventiation was performed to avoid a 'can't ventilate, can't intubate' situation. A size 3.5 air-Q intubating laryngeal airway was inserted using a bronchofiberscope to perform tracheal intubation in a semi-sitting position. Successful tracheal intubation which avoided damage to the tumor was achieved while maintaining spontaneous ventilation. The air-Q intubating laryngeal airway was useful in this setting of severe tracheal stenosis due to thyroid cancer just under the glottis.

摘要

一名75岁的女性因呼吸困难被诊断为恶性甲状腺癌导致严重气管狭窄。她计划接受紧急气管切开术,但术前计算机断层扫描显示由于甲状腺癌侵犯,声门以下存在严重气管狭窄。鉴于预计气管插管困难以及出血导致梗阻的风险,为避免出现“无法通气、无法插管”的情况,实施了保留自主通气的插管操作。在半卧位使用支气管纤维镜插入3.5号Air-Q插管型喉罩气道进行气管插管。在维持自主通气的同时成功完成了气管插管,避免了对肿瘤的损伤。Air-Q插管型喉罩气道在声门下方因甲状腺癌导致严重气管狭窄的情况下非常有用。

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