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一名患有慢性肾病并发扩张型心肌病的儿科患者在接受非心脏手术时的麻醉挑战。

Anesthetic Challenges in a Pediatric Patient With Chronic Kidney Disease Complicated by Dilated Cardiomyopathy Undergoing Non-cardiac Surgery.

作者信息

Kore Shilpa, Sharma Vipul, Garud Ishan

机构信息

Anesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Sep 29;16(9):e70477. doi: 10.7759/cureus.70477. eCollection 2024 Sep.

DOI:10.7759/cureus.70477
PMID:39479128
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11522663/
Abstract

Dilated cardiomyopathy (DCM), a primary myocardial disorder, manifests through the dilation of one or both ventricles, coupled with systolic and valvular dysfunction. Renal agenesis is a congenital condition characterized by the absence of one or both kidneys at birth. Unilateral renal agenesis, wherein one kidney is absent, can subtly evade detection due to the impressive adaptability of the remaining kidney, often preserving typical functionality. Nevertheless, when compounded with chronic kidney disease (CKD), the repercussions of renal agenesis become notably more pronounced. CKD and DCM represent two significant and interrelated clinical challenges, particularly in pediatrics. This case report examines the anesthesia management of a 10-year-old female with CKD and right renal agenesis complicated by DCM undergoing bilateral hemi-epiphysiodesis for genu valgum correction. It emphasizes the crucial role of a multidisciplinary approach in achieving favorable outcomes in patients undergoing non-cardiac surgery.

摘要

扩张型心肌病(DCM)是一种原发性心肌疾病,表现为一个或两个心室扩张,并伴有收缩功能和瓣膜功能障碍。肾缺如是一种先天性疾病,其特征是出生时一个或两个肾脏缺失。单侧肾缺如,即一侧肾脏缺失,由于剩余肾脏具有令人印象深刻的适应性,常常能保持典型功能,因此可能会巧妙地逃过检测。然而,当与慢性肾脏病(CKD)合并时,肾缺如的影响会变得更加明显。CKD和DCM是两个重大且相互关联的临床挑战,尤其是在儿科领域。本病例报告探讨了一名10岁患有CKD、右肾缺如并合并DCM的女性患者,在接受双侧半骨骺阻滞术以矫正膝外翻时的麻醉管理。它强调了多学科方法在接受非心脏手术患者获得良好预后方面的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1ac/11522663/98988f10e651/cureus-0016-00000070477-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1ac/11522663/98988f10e651/cureus-0016-00000070477-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1ac/11522663/98988f10e651/cureus-0016-00000070477-i01.jpg

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本文引用的文献

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Dilated cardiomyopathy.扩张型心肌病。
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