巨大气肿性肺大疱切除术的麻醉管理：一例报告

Lin Xianju, Wang Hongzhu, Yang Yong, Xiang Haifei

Department of Anesthesiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 317000, P.R. China.

Department of Anesthesiology, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 317000, P.R. China.

J Int Med Res. 2021 Apr;49(4):3000605211001989. doi: 10.1177/03000605211001989.

Anesthetic management for patients with a giant emphysematous bulla (GEB) is challenging. This case report describes a patient who developed 95% pulmonary compression by a GEB. A 14-Ga indwelling catheter was placed in the GEB before surgery to allow for slow re-expansion of the collapsed lung tissue. This prevented rupture of the GEB during anesthesia. Additionally, positive-pressure ventilation was performed to reduce the risk of re-expansion pulmonary edema. This respiratory management strategy may be beneficial for patients with a GEB who develop pulmonary dysfunction during thoracic surgery.

巨大气肿性肺大疱（GEB）患者的麻醉管理具有挑战性。本病例报告描述了一名患者，其肺部被GEB压迫了95%。术前在GEB中放置了一根14G的留置导管，以使塌陷的肺组织缓慢复张。这防止了麻醉期间GEB破裂。此外，进行了正压通气以降低复张性肺水肿的风险。这种呼吸管理策略可能对在胸外科手术期间出现肺功能障碍的GEB患者有益。