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一名患有威尔逊病的产妇剖宫产的麻醉管理:病例报告

Anesthetic management of cesarean delivery for a parturient with Wilson's disease: A case report.

作者信息

Wan Yantong, Jiang Xiaoqin, Lin Xuemei

机构信息

Department of Anesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China.

出版信息

Medicine (Baltimore). 2018 May;97(20):e10454. doi: 10.1097/MD.0000000000010454.

DOI:10.1097/MD.0000000000010454
PMID:29768321
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5976292/
Abstract

RATIONALE

Wilson's disease (WD), or hepatolenticular degeneration, is an autosomal recessive disorder with a prevalence of 1:50,000 to 1:100,000 live births.

PATIENT CONCERNS

A 26-year-old primipara with WD was admitted to our hospital, due to awaiting delivery. Her main symptoms were slightly higher total bile acid (TBA) and bilateral depressed edema of lower limbs.

DIAGNOSIS

She was at 38 weeks and 4 days of gestation with a 15-year history of WD, controlled with penicillamine in the past and replaced by zinc preparations from three months before pregnancy.

OUTCOMES

General anesthesia was successfully administered for a female with WD undergoing cesarean delivery.

LESSON

General anesthesia can be administered in an asymptomatic primigravida with WD. Appropriate anesthetics choice can effectively minimize the rates of complications and sequelae.

摘要

理论依据

威尔逊病(WD),即肝豆状核变性,是一种常染色体隐性疾病,活产患病率为1:50,000至1:100,000。

患者情况

一名26岁患有WD的初产妇因待产入院。她的主要症状是总胆汁酸(TBA)略高和双下肢凹陷性水肿。

诊断

她妊娠38周零4天,有15年WD病史,过去用青霉胺控制,妊娠前三个月改用锌制剂。

结果

一名患有WD的女性剖宫产手术中全身麻醉成功实施。

经验教训

全身麻醉可用于无症状的WD初产妇。选择合适的麻醉剂可有效降低并发症和后遗症的发生率。

相似文献

1
Anesthetic management of cesarean delivery for a parturient with Wilson's disease: A case report.一名患有威尔逊病的产妇剖宫产的麻醉管理:病例报告
Medicine (Baltimore). 2018 May;97(20):e10454. doi: 10.1097/MD.0000000000010454.
2
[Pregnancy, labor and early puerperium in a patient with Wilson's disease].[肝豆状核变性患者的妊娠、分娩及产褥早期]
Ceska Gynekol. 1999 Jun;64(3):198-200.
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Pregnancy and penicillamine treatment in a patient with Wilson's disease.一名威尔逊病患者的妊娠与青霉胺治疗
Jpn J Med. 1986 Feb;25(1):59-62. doi: 10.2169/internalmedicine1962.25.59.
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Pregnancy in a patient with Wilson's disease treated with D-penicillamine and zinc sulfate. A case report and review of the literature.用青霉胺和硫酸锌治疗的威尔逊病患者的妊娠。病例报告及文献复习。
Eur Neurol. 1994;34(6):337-40. doi: 10.1159/000117074.
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Compliant treatment with anti-copper agents prevents clinically overt Wilson's disease in pre-symptomatic patients.有症状前患者采用抗铜药物进行规范治疗可预防出现临床显性威尔逊病。
Eur J Neurol. 2014 Feb;21(2):332-7. doi: 10.1111/ene.12320. Epub 2013 Dec 7.
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Wilson's disease and pregnancy.威尔逊氏病与妊娠
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Maintenance zinc therapy after initial penicillamine chelation to treat symptomatic hepatic Wilson's disease in resource constrained setting.在资源有限的环境中,初始青霉胺螯合治疗有症状的肝豆状核变性后进行维持性锌治疗。
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Effect of penicillamine and zinc on iron metabolism in Wilson's disease.青霉胺和锌对肝豆状核变性患者铁代谢的影响。
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Diagnosis and treatment of Wilson's disease.肝豆状核变性的诊断与治疗
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Am J Gastroenterol. 1999 Feb;94(2):334-8. doi: 10.1111/j.1572-0241.1999.851_w.x.

引用本文的文献

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Challenges in Anesthesia in Wilson's Disease: A Systematic Review of the Existing Literature.威尔逊氏病麻醉的挑战:对现有文献的系统评价
Cureus. 2023 Jan 4;15(1):e33334. doi: 10.7759/cureus.33334. eCollection 2023 Jan.
2
The Maternal and Fetal Outcomes of Pregnancy in Wilson's Disease: A Systematic Literature Review and Meta-Analysis.威尔逊病患者妊娠的母婴结局:系统文献综述与荟萃分析
Biomedicines. 2022 Aug 24;10(9):2072. doi: 10.3390/biomedicines10092072.
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Perioperative anesthetic management for cesarean delivery of severe Wilson's disease with liver failure: a case report.重度威尔逊病合并肝功能衰竭剖宫产术的围手术期麻醉管理:一例报告
JA Clin Rep. 2019 Nov 13;5(1):75. doi: 10.1186/s40981-019-0294-2.
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Wilson disease - Challenge for safe anesthesia!威尔逊病——安全麻醉面临的挑战!
Saudi J Anaesth. 2019 Oct-Dec;13(4):384-385. doi: 10.4103/sja.SJA_12_19.

本文引用的文献

1
General anesthesia for caesarean section.剖宫产术的全身麻醉。
Curr Opin Anaesthesiol. 2015 Jun;28(3):240-6. doi: 10.1097/ACO.0000000000000185.
2
Wilson's disease in pregnancy: case series and review of literature.妊娠期威尔逊病:病例系列及文献综述
BMC Res Notes. 2013 Oct 18;6:421. doi: 10.1186/1756-0500-6-421.
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Perioperative management of Wilson disease for therapeutic abortion: a report.
Minerva Anestesiol. 2013 Oct;79(10):1200-1. Epub 2013 May 2.
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Anesthetic management of a pediatric patient with wilsons disease.一名患有威尔逊氏病的儿科患者的麻醉管理。
J Clin Med Res. 2010 Mar 20;2(2):99-101. doi: 10.4021/jocmr2010.04.292w.
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Anesthesia for a patient with Wilson's disease--a case report.
Middle East J Anaesthesiol. 2008 Feb;19(4):905-8.
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Kidneys contribute to the extrahepatic clearance of propofol in humans, but not lungs and brain.肾脏对丙泊酚在人体中的肝外清除有作用,但肺和脑没有。
Br J Clin Pharmacol. 2005 Aug;60(2):176-82. doi: 10.1111/j.1365-2125.2005.02393.x.
7
Treatment of Wilson's disease with zinc: XV long-term follow-up studies.锌治疗肝豆状核变性:十五项长期随访研究
J Lab Clin Med. 1998 Oct;132(4):264-78. doi: 10.1016/s0022-2143(98)90039-7.