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孕期及产后连续脊柱手术的麻醉管理

Anaesthetic Management in Successive Spinal Surgeries During Pregnancy and Postpartum.

作者信息

Coşkun Demet, Mahli Ahmet, Sabuncu Ülkü, Özdemir Rabia, Emmez Hakan, Günaydın Dudu Berrin

机构信息

Department of Anaesthesiology and Reanimation, Gazi University School of Medicine, Ankara, Turkey.

Department of Anaesthesiology and Reanimation, Yüksek İhtisas University School of Medicine, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2020 Oct;48(5):420-422. doi: 10.5152/TJAR.2020.31698. Epub 2020 Feb 5.

Abstract

In this case report, we present a parturient with spinal tumour who required neurosurgery before and after caesarean delivery under general anaesthesia. A 25-year-old woman at 30 weeks of gestation and suffering from bilateral lower-limb weakness and sensory deficit due to spinal tumour underwent emergent laminectomy and decompression surgery under general anaesthesia. In this case, total intravenous anaesthesia was used. Two weeks later, the patient underwent emergent caesarean delivery under general anaesthesia due to preterm labour and gave birth to a healthy new-born. Meanwhile, pathological exam revealed soft tissue sarcoma requiring re-operation for gross total excision in the postpartum Week 4, which was followed by multisession chemoradiotherapy. The patient survived for 3 years, that is, until generalised systemic and neural metastasis. General anaesthesia management in surgeries before and after caesarean delivery in patients with spinal tumours is of utmost importance in providing optimal maternal, foetal and neonatal safety using a multidisciplinary team approach.

摘要

在本病例报告中,我们介绍了一名患有脊柱肿瘤的产妇,她在全身麻醉下剖宫产前后均需要进行神经外科手术。一名25岁、妊娠30周的女性因脊柱肿瘤导致双侧下肢无力和感觉障碍,在全身麻醉下接受了急诊椎板切除术和减压手术。本病例采用了全静脉麻醉。两周后,患者因早产在全身麻醉下接受了急诊剖宫产,产下一名健康新生儿。同时,病理检查显示为软组织肉瘤,需要在产后第4周再次手术进行根治性切除,随后进行多疗程放化疗。患者存活了3年,直至发生全身和神经转移。对于患有脊柱肿瘤的患者,剖宫产前后手术中的全身麻醉管理对于采用多学科团队方法确保产妇、胎儿和新生儿的最佳安全至关重要。

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