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纵隔肿物致上腔静脉阻塞剖宫产患者的麻醉管理

Anaesthetic Management for Caesarean Delivery Patient with Obstructed Superior Vena Cava by Mediastinal Mass.

作者信息

Pattaratuma Vanda, Chandee Theerada, Saiphoklang Narongkorn

出版信息

J Med Assoc Thai. 2016 Nov;99 Suppl 8:S222-S226.

Abstract

Maternal anatomical and physiological changes occur during pregnancy, particularly with cardiovascular and respiratory systems. Pregnant women with large mediastinal mass additionally have an increased risk of cardiopulmonary compromise. We report a 31-year-old patient at 30 weeks of gestation with a large anterior mediastinal tumour with superior vena cava obstruction. Her presenting symptom was progressive and severe dyspnea due to the large mediastinal mass. An ultrasound-guided biopsy was performed and the pathologic result was Hodgkin’s lymphoma. Termination of pregnancy and delivery of the neonate were performed using a Caesarean delivery under spinal anesthesia in the sitting position. The perioperative anaesthetic management was successful without any serious complications, and the postoperative outcomes were very impressive.

摘要

孕期会发生母体解剖和生理变化,尤其是心血管和呼吸系统。患有巨大纵隔肿块的孕妇发生心肺功能不全的风险更高。我们报告一名31岁、孕30周的患者,患有巨大前纵隔肿瘤并伴有上腔静脉梗阻。她的主要症状是由于巨大纵隔肿块导致的进行性严重呼吸困难。进行了超声引导下活检,病理结果为霍奇金淋巴瘤。在坐位下采用脊髓麻醉行剖宫产终止妊娠并娩出新生儿。围手术期麻醉管理成功,无任何严重并发症,术后结果非常理想。

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