Pattaratuma Vanda, Chandee Theerada, Saiphoklang Narongkorn
J Med Assoc Thai. 2016 Nov;99 Suppl 8:S222-S226.
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.
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。