Delfino J J, Sclaroff A, Giglio J A, Travis M
J Oral Surg. 1978 Nov;36(11):890-2.
Patients with a history of hereditary angioneurotic edema can adequate and safely have nonelective surgical procedures performed with proper preoperative and postoperative management. Deficient amounts of C1 esterase inhibitor can be replaced with fresh frozen plasma; capillary permeability and spreading edema can be prevented with antifibrinolytic agents such as Amicar. Once edema has occurred peripherally and no laryngeal symptoms are present, conservative treatment is advisable. When epiglottic and laryngeal edema occurs, intubation or tracheostomy is preferred for maintenance of airway until the edema subsides. During oral surgical procedures, minimal surgical trauma must be achieved. Edema that involves the airway presents the greatest danger to patients. These attacks are usually associated with dental or some sort of oral or pharyngeal manipulation.
有遗传性血管性水肿病史的患者，在进行适当的术前和术后管理后，能够安全地进行非选择性外科手术。C1酯酶抑制剂缺乏时可用新鲜冷冻血浆替代；可用抗纤维蛋白溶解剂如氨基己酸预防毛细血管通透性增加和扩散性水肿。一旦外周出现水肿且无喉部症状，建议采取保守治疗。当会厌和喉部水肿发生时，优先进行插管或气管切开以维持气道通畅，直至水肿消退。在口腔外科手术过程中，必须尽量减少手术创伤。累及气道的水肿对患者构成最大危险。这些发作通常与牙科治疗或某种口腔或咽部操作有关。
