休克状态下未矫正法洛四联症产妇的管理：麻醉挑战
Management of a parturient with uncorrected tetralogy of Fallot in shock: an anesthetic challenge.
作者信息
Bellapukonda Snigdha, Roncall Bhim Raju, Mund Manisha
机构信息
Anaesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Anaesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
出版信息
BMJ Case Rep. 2019 Dec 2;12(12):e231517. doi: 10.1136/bcr-2019-231517.
Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. The survival of patients with uncorrected TOF till the fourth decade of life is rare (around 3%). Pregnancy in a patient with uncorrected TOF requires a multidisciplinary approach. A confluence of pregnancy, uncorrected TOF and shock is infrequent. The state of hypovolaemia and a decrease in systemic vascular resistance due to anaesthetic agents increase the right to left shunt. The decrease in pulmonary blood flow provokes a 'hypercyanotic spell'. We report the successful management of 30-year-old pregnant (G3P2A2L0) with uncorrected TOF, presenting to the emergency department with incomplete abortion in shock.
法洛四联症（TOF）是最常见的青紫型先天性心脏病。未经矫正的TOF患者活到四十岁的情况很罕见（约3%）。未经矫正的TOF患者怀孕需要多学科方法处理。怀孕、未经矫正的TOF和休克同时出现的情况并不常见。由于麻醉药物导致的低血容量状态和体循环血管阻力降低会增加右向左分流。肺血流量减少会引发“缺氧发作”。我们报告了一例30岁、孕3产2流产2次无产的未经矫正TOF孕妇，因不全流产伴休克就诊于急诊科，最终成功救治的病例。
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