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孕中期长时间入住重症监护病房且存在绝对禁忌证无法进行椎管内阻滞的T5截瘫患者行剖宫产术。

Caesarean delivery in T5 paraplegic following extended ICU stay in second trimester with absolute contraindication to neuraxial blocks.

作者信息

Granovskiy Felix, Greenwood Adam, Jackson Christopher

机构信息

The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

出版信息

BMJ Case Rep. 2021 Apr 8;14(4):e240307. doi: 10.1136/bcr-2020-240307.

Abstract

Pregnancy in patients with spinal cord injury presents unique challenges to their care teams. While spinal cord injury alters the function of several organ systems, one of the most important consequences is autonomic dysreflexia. Anaesthesia providers must be familiar with the pathophysiology and management of gravid patients with spinal cord injury to manage their deliveries successfully. A multidisciplinary team is essential; close collaboration between the obstetrical and anaesthesiology teams is crucial. The authors will present a case of a successful caesarean delivery in a woman with a T5 injury as well as a recent epidural abscess using general endotracheal anaesthesia.

摘要

脊髓损伤患者怀孕给其护理团队带来了独特的挑战。虽然脊髓损伤会改变多个器官系统的功能,但最重要的后果之一是自主神经反射异常。麻醉医生必须熟悉脊髓损伤孕妇的病理生理学和管理方法,以便成功处理她们的分娩。多学科团队至关重要;产科和麻醉科团队之间的密切合作至关重要。作者将介绍一例T5损伤女性成功进行剖宫产的病例,以及最近一例使用全身气管内麻醉治疗硬膜外脓肿的病例。

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