Crawford M, Burns R, Cooper S, Mackay T
Anaesthetic Department, Royal Infirmary of Edinburgh, 51 Little France Dr, Edinburgh, UK.
Anaesthetic Department, Royal Infirmary of Edinburgh, 51 Little France Dr, Edinburgh, UK.
Int J Obstet Anesth. 2018 Feb;33:84-86. doi: 10.1016/j.ijoa.2017.11.002. Epub 2017 Nov 13.
Hereditary haemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is a rare autosomal dominant multisystem disorder, characterised by mucocutaneous telangiectases and arteriovenous malformations affecting any organ. The physiological changes in pregnancy pose significant obstetric and anaesthetic challenges for women affected by the disease. The optimal timing and mode of delivery requires careful consideration; and the benefits and risks of both regional and general anaesthetic techniques must be carefully considered, depending on the organs affected. This case report describes the successful management of a patient with this disease and severe pulmonary involvement, who received both regional and general anaesthesia as a result of a complication in the initial anaesthetic plan. The report demonstrates the benefits of a multidisciplinary approach to a complex case, achieved through providing care in a tertiary centre with appropriate expertise and resources.
遗传性出血性毛细血管扩张症,又称奥斯勒-韦伯-伦杜病,是一种罕见的常染色体显性多系统疾病,其特征为黏膜皮肤毛细血管扩张和影响任何器官的动静脉畸形。妊娠期间的生理变化给患此病的女性带来了重大的产科和麻醉挑战。最佳分娩时机和方式需要仔细考虑;根据受影响的器官,必须仔细权衡区域麻醉和全身麻醉技术的利弊。本病例报告描述了一名患有该疾病且肺部严重受累的患者的成功管理过程,该患者因初始麻醉计划中的并发症而接受了区域麻醉和全身麻醉。该报告展示了通过在具备适当专业知识和资源的三级中心提供护理,对复杂病例采取多学科方法的益处。