Michelsen L G, Vanderspek A F
University of Michigan Medical Center, C.S. Mott Children's Hospital, Ann Arbor 48109-0800.
Anaesthesia. 1988 Dec;43(12):1028-30. doi: 10.1111/j.1365-2044.1988.tb05702.x.
A case of acute respiratory obstruction in the immediate postoperative period is described in a young woman who emerged from general anaesthesia after a Caesarean section for fetal distress. She had a pregnancy complicated by disabling polyhydramnios and anxiously anticipated the birth of a child with a diaphragmatic hernia, diagnosed antenatally. The cause of the airway obstruction was functional in nature as confirmed by flexible fibreoptic laryngoscopy. The diagnosis, paradoxical vocal cord motion, has to be considered as an infrequent cause of postoperative airway obstruction; its recognition and treatment are discussed. The patient did not have a history which might have indicated its possible occurrence. It is suggested that paradoxical vocal cord movement in a more mild form may be overlooked as cause for postoperative stridor and airway obstruction.
本文描述了一名年轻女性在剖宫产术后即刻发生急性呼吸梗阻的病例。该女性因胎儿窘迫接受剖宫产，术后从全身麻醉中苏醒。她的孕期合并严重羊水过多，且因产前诊断胎儿患有膈疝而焦虑地期待孩子的出生。经可弯曲纤维喉镜检查证实，气道梗阻的原因本质上是功能性的。诊断为反常性声带运动，这是术后气道梗阻的一种罕见原因；文中讨论了其识别和治疗方法。该患者既往史中并无提示可能发生此病的情况。有人认为，较为轻微形式的反常性声带运动可能会被忽视，而未被视为术后喘鸣和气道梗阻的原因。
