Rosay H, Lançon J P, Oeuvrard C, Bernard A, Caillard B
Département d'Anesthésie-Réanimation, Centre Hospitalier Régional et Universitaire, Hôpital du Bocage, Dijon.
Ann Fr Anesth Reanim. 1988;7(6):509-10. doi: 10.1016/s0750-7658(88)80090-x.
A case is reported of isolated bronchospasm occurring during the removal of two hydatid cysts in the same patient at the same time. This 44 year old man already had had a hydatid cyst removed one year previously; no complication had occurred at the time. The patient had a past history of asthma, easily treated by salbutamol spray. All went well until the first cyst was manipulated: the ventilating pressures rose, and wheezing rhonchi appeared in both lung fields. This bronchospasm was resistant to an increase in anaesthetic depth, to salbutamol, terbutaline, steroids and 3% halothane for 15 min. It however disappeared completely as soon as the cyst was removed. There were no other signs of an anaphylactic reaction. The same thing occurred during the removal of the second cyst. Postoperative investigations showed the patient to be sensitized to house dust and mites. His asthma is confirmed. Allergologic tests showed no reaction with the anaesthetic drugs used, but a hypersensitivity to the echinococcal antigens. The bronchospasm was probably due to the increased bronchial sensitivity of this patient.
本文报告了一例在同一患者同时摘除两个包虫囊肿过程中发生的孤立性支气管痉挛病例。该44岁男性患者一年前已摘除过一个包虫囊肿，当时未发生并发症。患者有哮喘病史，使用沙丁胺醇喷雾剂易于治疗。在操作第一个囊肿之前一切顺利，但在操作第一个囊肿时，通气压力升高，双肺野出现哮鸣音。这种支气管痉挛对麻醉深度增加、沙丁胺醇、特布他林、类固醇及3%氟烷持续15分钟均无反应。然而，一旦囊肿摘除，支气管痉挛立即完全消失。未出现其他过敏反应迹象。摘除第二个囊肿时发生了同样的情况。术后检查显示患者对屋尘和螨虫敏感，哮喘得到确诊。变应原学检测显示对所用麻醉药物无反应，但对棘球蚴抗原过敏。支气管痉挛可能是由于该患者支气管敏感性增加所致。
