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一名患有下颅神经损伤的放疗后鼻咽癌患者在全身麻醉苏醒期间突发气道梗阻:病例报告。

Sudden airway obstruction during emergence from general anesthesia in a post-radiation nasopharyngeal carcinoma patient with lower cranial nerve injury: A case report.

作者信息

Zhu Wei-Chao, Hu Li, Kang Shuai

机构信息

Department of Anesthesiology, Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China.

出版信息

J Int Med Res. 2025 Mar;53(3):3000605251325655. doi: 10.1177/03000605251325655. Epub 2025 Mar 21.

DOI:10.1177/03000605251325655
PMID:40116801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11930465/
Abstract

This article presents a case study of airway obstruction encountered during the post-anesthetic recovery period in a patient with nasopharyngeal carcinoma who had suffered cranial nerve damage subsequent to radiation therapy. It underscores the necessity for meticulous preoperative preparation during the induction of anesthesia and a comprehensive assessment coupled with careful preparation prior to extubation in the recovery phase. These measures are crucial to guarantee the safety of perioperative anesthesia in such patients. The case report is intended to contribute to the clinical knowledge base for anesthesiologists managing patients with nasopharyngeal carcinoma who have experienced post-radiation cranial nerve impairment. This case report has been meticulously crafted in compliance with the CARE (Case Reports) guideline, ensuring a standardized and rigorous approach to presenting the patient's medical history, diagnosis, treatment, and outcomes.

摘要

本文介绍了一例鼻咽癌患者在放疗后出现颅神经损伤,在麻醉后恢复期发生气道梗阻的病例研究。它强调了麻醉诱导期间进行细致的术前准备以及在恢复期拔管前进行全面评估并精心准备的必要性。这些措施对于确保此类患者围手术期麻醉的安全至关重要。该病例报告旨在为管理放疗后颅神经受损的鼻咽癌患者的麻醉医生提供临床知识库。本病例报告严格按照CARE(病例报告)指南精心撰写,确保以标准化、严谨的方式呈现患者的病史、诊断、治疗及结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/8b969bdd1207/10.1177_03000605251325655-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/757bf6a40540/10.1177_03000605251325655-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/012e4939d840/10.1177_03000605251325655-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/8b969bdd1207/10.1177_03000605251325655-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/757bf6a40540/10.1177_03000605251325655-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/012e4939d840/10.1177_03000605251325655-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82af/11930465/8b969bdd1207/10.1177_03000605251325655-fig3.jpg

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本文引用的文献

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Cancers (Basel). 2024 Jul 15;16(14):2540. doi: 10.3390/cancers16142540.
2
PREOPERATIVE SINGLE ANTHROPOMETRIC SCREENING TESTS OF DIFFICULT FACE MASK VENTILATION AND DIFFICULT DIRECT LARYNGOSCOPY INTUBATION IN PATIENTS UNDERGOING OTORHINOLARYNGOLOGICAL SURGERY: A PROSPECTIVE, OBSERVATIONAL, SINGLE CENTER STUDY.术前单一人体测量学筛查试验在接受耳鼻喉科手术的患者中评估面罩通气困难和直接喉镜插管困难:一项前瞻性、观察性、单中心研究。
Acta Clin Croat. 2023 Apr;62(Suppl1):9-20. doi: 10.20471/acc.2023.62.s1.01.
3
In Response to "Difficult Tracheal Intubation and Airway Outcomes After Radiation for Nasopharyngeal Carcinoma".
回应《鼻咽癌放疗后的困难气管插管与气道结局》
Laryngoscope. 2023 Dec;133(12):E68. doi: 10.1002/lary.30945. Epub 2023 Aug 9.
4
In Reference to Difficult Tracheal Intubation and Airway Outcomes After Radiation for Nasopharyngeal Carcinoma.关于鼻咽癌放疗后的困难气管插管及气道结局
Laryngoscope. 2023 Dec;133(12):E67. doi: 10.1002/lary.30948. Epub 2023 Aug 9.
5
Difficult Tracheal Intubation and Airway Outcomes after Radiation for Nasopharyngeal Carcinoma.鼻咽癌放疗后困难气管插管和气道结果。
Laryngoscope. 2024 Jan;134(1):120-126. doi: 10.1002/lary.30767. Epub 2023 May 30.
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Impairment mechanism of nasal mucosa after radiotherapy for nasopharyngeal carcinoma.鼻咽癌放疗后鼻黏膜损伤机制
Front Oncol. 2022 Dec 15;12:1010131. doi: 10.3389/fonc.2022.1010131. eCollection 2022.
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Risk factors for reintubation and mortality among patients who had unplanned extubation.非计划性拔管患者再次插管及死亡的危险因素。
Nurs Crit Care. 2023 Jan;28(1):56-62. doi: 10.1111/nicc.12777. Epub 2022 Apr 17.
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Pelvic bone marrow sparing radiotherapy for cervical cancer: A systematic review and meta-analysis.宫颈癌骨盆骨髓保护放疗:系统评价和荟萃分析。
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