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新型冠状病毒 SARS-CoV-2 感染患者肺转移切除术的麻醉管理。

Anaesthetic Management of Pulmonary Metastasectomy in a Patient Infected with Novel Corona Virus SARS-CoV-2.

机构信息

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Oman.

Anesthesia Residency Training Program, Oman Medical Specialty Board, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2022 Nov;22(4):578-582. doi: 10.18295/squmj.9.2021.137. Epub 2022 Nov 7.

DOI:10.18295/squmj.9.2021.137
PMID:36407706
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9645507/
Abstract

Prioritisation of individual patients for thoracic surgeries gained importance during the current COVID-19 pandemic to ensure optimal utilisation of resources. We report a 76-year-old-male patient who presented to a tertiary care hospital in Muscat, Oman, 2020, with bilateral pulmonary metastasis. The patient underwent an urgent pulmonary metastasectomy with successful anaesthesia management in an elderly patient despite him testing positive for COVID-19 twice via real-time reverse transcription-polymerase chain reaction. At the 3-month follow-up some pulmonary abnormalities persisted but the patient was recovering well. This report discusses the rationale to perform surgery in this case and highlights the precautions taken for reducing aerosol generation during the various stages of anaesthesia.

摘要

在当前 COVID-19 大流行期间，为了确保资源的最佳利用，对胸外科手术的个体患者进行优先排序变得尤为重要。我们报告了一位 76 岁男性患者，他于 2020 年在阿曼马斯喀特的一家三级护理医院就诊，患有双侧肺转移。尽管该患者两次通过实时逆转录-聚合酶链反应检测出 COVID-19 呈阳性，但他还是接受了紧急肺转移切除术，并在老年患者中成功进行了麻醉管理。在 3 个月的随访中，一些肺部异常仍然存在，但患者恢复良好。本报告讨论了在这种情况下进行手术的基本原理，并强调了在麻醉的各个阶段采取的减少气溶胶生成的预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/01131736e365/squmj2211-578-582f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/ae88e1a0753c/squmj2211-578-582f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/33cd58f249b0/squmj2211-578-582f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/01131736e365/squmj2211-578-582f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/ae88e1a0753c/squmj2211-578-582f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/33cd58f249b0/squmj2211-578-582f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/9645507/01131736e365/squmj2211-578-582f3.jpg

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Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.
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Anaesthesia. 2021 Jun;76(6):748-758. doi: 10.1111/anae.15458. Epub 2021 Mar 9.
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Association of SARS-CoV-2 Genomic Load with Outcomes in Patients with COVID-19.严重急性呼吸综合征冠状病毒2基因组载量与新型冠状病毒肺炎患者预后的关联
Ann Am Thorac Soc. 2021 May;18(5):900-903. doi: 10.1513/AnnalsATS.202008-931RL.
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