一名胸椎刺伤患者俯卧位下纤维支气管镜引导气管插管：病例报告
Fiberoptic bronchoscopy-guided endotracheal intubation in prone position for a patient with a thoracic spinal stab wound: a case report.
作者信息
Zhou Jianwei, Zhu Kailai, Wang Chuanguang, Zhu Ye
机构信息
Department of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Zhejiang Province, Lishui, 323000, China.
Department of Orthopedics, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Zhejiang Province, Lishui, 323000, China.
出版信息
J Med Case Rep. 2025 Jul 1;19(1):294. doi: 10.1186/s13256-025-05354-4.
BACKGROUND
Position changes in patients with thoracic spinal stab wounds may cause displacement of embedded sharp objects, increasing the risk of spinal cord or surrounding tissue injury. Management of these cases under anesthesia requires a carefully planned approach to minimize movement and ensure patient safety.
CASE PRESENTATION
A 59-year-old Han Chinese male was admitted to the hospital due to "back pain and bleeding caused by stab wounds for 2 hours." The patient was at high risk of secondary spinal cord injury and aspiration due to an embedded foreign object and a full stomach state. Fiberoptic bronchoscopy-guided endotracheal intubation was successfully performed in the prone position under mild sedation.
CONCLUSION
This case highlights the feasibility and safety of awake fiberoptic bronchoscopy-guided intubation in the prone position and provides valuable insights for managing similar high-risk scenarios in clinical practice.
背景
胸段脊柱刺伤患者的体位改变可能导致嵌入的锐器移位，增加脊髓或周围组织损伤的风险。在麻醉下处理这些病例需要精心规划的方法，以尽量减少活动并确保患者安全。
病例介绍
一名59岁的汉族男性因“刺伤致背痛、出血2小时”入院。由于有异物嵌入和胃饱满状态，该患者继发脊髓损伤和误吸的风险很高。在轻度镇静下于俯卧位成功进行了纤维支气管镜引导下气管插管。
结论
本病例突出了清醒状态下纤维支气管镜引导下俯卧位插管的可行性和安全性，并为临床实践中处理类似的高风险情况提供了有价值的见解。
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