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一名患有肢端肥大症和多结节性甲状腺肿的患者接受内镜垂体手术时的麻醉挑战。

Anaesthetic challenges in a patient with acromegaly and multinodular goitre undergoing endoscopic pituitary surgery.

作者信息

Jamil Jabraan, Wan Hassan Wan Mohd Nazarudin, Ghani Ab Rahman, Yeap Tat Boon

机构信息

Anaesthesia and Intensive Care Unit, Hospital Queen Elizabeth, Kota Kinabalu, Malaysia.

Department of Anaesthesia and Intensive Care, Universiti Sains Malaysia, Kota Bharu, Malaysia.

出版信息

BMJ Case Rep. 2023 Feb 16;16(2):e250640. doi: 10.1136/bcr-2022-250640.

Abstract

Acromegaly is a progressive systemic disorder which is common among middle-aged women. A functioning growth hormone-secreting pituitary adenoma is the most common cause. Anaesthesia for pituitary surgery in patients with acromegaly is challenging. Rarely, these patients may develop thyroid lesions that may compromise the airway. We present the case of a young man with newly diagnosed acromegaly caused by a pituitary macroadenoma complicated by a large multinodular goitre. The aim of this report is to discuss the perianaesthetic approach in patients with acromegaly with a high risk of airway compromise undergoing pituitary surgery.

摘要

肢端肥大症是一种进行性全身性疾病,在中年女性中较为常见。功能性分泌生长激素的垂体腺瘤是最常见的病因。肢端肥大症患者垂体手术的麻醉具有挑战性。这些患者很少会出现可能危及气道的甲状腺病变。我们报告一例年轻男性,新诊断为垂体大腺瘤合并巨大结节性甲状腺肿所致的肢端肥大症。本报告的目的是讨论垂体手术气道受损风险高的肢端肥大症患者的围麻醉处理方法。

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本文引用的文献

1
Anesthetic management during transsphenoidal pituitary surgery.经蝶窦垂体手术的麻醉管理。
Curr Opin Anaesthesiol. 2021 Oct 1;34(5):575-581. doi: 10.1097/ACO.0000000000001035.
8
Management of hormone-secreting pituitary adenomas.激素分泌性垂体腺瘤的管理
Neuro Oncol. 2017 Jun 1;19(6):762-773. doi: 10.1093/neuonc/now130.
10
Acromegaly: an endocrine society clinical practice guideline.肢端肥大症:内分泌学会临床实践指南。
J Clin Endocrinol Metab. 2014 Nov;99(11):3933-51. doi: 10.1210/jc.2014-2700. Epub 2014 Oct 30.

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