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采用创新定位策略行经皮肾镜取石术的强直性脊柱炎合并多种并发症患者的管理

Management of a Patient With Ankylosing Spondylitis and Multiple Comorbidities Who Underwent a Percutaneous Nephrolithotomy Using an Innovative Positioning Strategy.

作者信息

Mahaseth Ranjay, Dhar Mridul, Challa Revanth B, Panwar Vikas K, Chaudhary Ravi

机构信息

Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, IND.

Anaesthesiology, All India Institute of Medical Sciences, Nagpur, IND.

出版信息

Cureus. 2024 Jan 1;16(1):e51455. doi: 10.7759/cureus.51455. eCollection 2024 Jan.

DOI:10.7759/cureus.51455
PMID:38298317
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10829528/
Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory disorder leading to bony ankylosis, ossification, and fibrosis of the spine. Airway management is difficult in these patients due to restricted head and neck movement as well as a stiff body posture. This also poses challenges in lying down supine as well as surgical positioning. We report a case of a patient with AS and multiple co-morbidities who underwent a percutaneous nephrolithotomy for renal calculi, and the customisations made in anaesthetic and surgical techniques to safely perform the procedure.

摘要

强直性脊柱炎（AS）是一种慢性炎症性疾病，可导致脊柱骨质融合、骨化和纤维化。由于头颈部活动受限以及身体姿势僵硬，这些患者的气道管理困难。这在仰卧位及手术体位摆放方面也带来了挑战。我们报告一例患有AS及多种合并症的患者，该患者因肾结石接受了经皮肾镜取石术，以及为安全实施该手术而在麻醉和手术技术方面所做的调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6c3/10829528/8ae1874c2600/cureus-0016-00000051455-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6c3/10829528/88228076b587/cureus-0016-00000051455-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6c3/10829528/8ae1874c2600/cureus-0016-00000051455-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6c3/10829528/88228076b587/cureus-0016-00000051455-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6c3/10829528/8ae1874c2600/cureus-0016-00000051455-i02.jpg

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本文引用的文献

1
Dramatic Cervical Spine Injury Secondary to Videolaryngoscopy in a Patient Suffering from Ankylosing Spondylitis.强直性脊柱炎患者因视频喉镜检查继发严重颈椎损伤
Anesthesiology. 2021 Sep 1;135(3):495-496. doi: 10.1097/ALN.0000000000003866.
2
Supine percutaneous nephrolithotomy: tips and tricks.仰卧位经皮肾镜取石术：技巧与窍门
Transl Androl Urol. 2019 Sep;8(Suppl 4):S381-S388. doi: 10.21037/tau.2019.07.09.
3
Percutaneous Nephrolithotomy: Current Clinical Opinions and Anesthesiologists Perspective.经皮肾镜取石术：当前临床观点及麻醉医生视角
Anesthesiol Res Pract. 2016;2016:9036872. doi: 10.1155/2016/9036872. Epub 2016 Mar 27.
4
Anesthetic consideration in a patient with giant bilateral lung bullae with severe respiratory compromise.患有巨大双侧肺大疱且伴有严重呼吸功能不全患者的麻醉考量。
Saudi J Anaesth. 2015 Oct-Dec;9(4):493-5. doi: 10.4103/1658-354X.165128.
5
Ankylosing spondylitis: recent developments and anaesthetic implications.
Anaesthesia. 2009 May;64(5):540-8. doi: 10.1111/j.1365-2044.2008.05794.x.