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体外膜肺氧合与硬质支气管镜辅助下儿童巨大肺间质性肿瘤手术切除:1例报告

ECMO and rigid bronchoscopy-assisted surgical resection of a giant pulmonary mesenchymal tumor in a child: a case report.

作者信息

Xiong Xinghui, Du Bin

机构信息

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

BMC Pediatr. 2025 Jul 29;25(1):573. doi: 10.1186/s12887-025-05951-8.

Abstract

BACKGROUND

Giant pulmonary mesenchymal tumors in children pose significant challenges in pediatric anesthesia practice. During resection, these tumors can lead to complications such as cardiovascular collapse during anesthesia induction and injury to adjacent organs or blood vessels that may be compressed or displaced.

CASE PRESENTATION

A 3-year-old girl presented to the pediatric clinic with cough, wheezing, and orthopnea (inability to lie flat due to dyspnea). After a diagnosis of giant pulmonary mesenchymal tumor, she underwent complete resection under extracorporeal membrane oxygenation (ECMO) and high-frequency ventilation, with rigid bronchoscopy used for airway management. ECMO was successfully discontinued, and the tracheal tube was extubated 3 days later. At 4-week follow-up, her symptoms significantly resolved, and no neurological or cardiovascular complications were reported.

CONCLUSIONS

This is one of the few detailed reports of a pediatric pulmonary mesenchymal tumor managed with ECMO and rigid bronchoscopy so far. Preoperative multidisciplinary cooperation, ECMO, and rigid bronchoscopy are critical for the successful resection of pediatric pulmonary mesenchymal tumors and may significantly improve long-term outcomes in pediatric patients.

摘要

背景

儿童巨大肺间质性肿瘤给小儿麻醉实践带来重大挑战。在切除过程中,这些肿瘤可导致并发症,如麻醉诱导期间的心血管崩溃以及对可能被压迫或移位的相邻器官或血管的损伤。

病例报告

一名3岁女孩因咳嗽、喘息和端坐呼吸(因呼吸困难无法平卧)就诊于儿科诊所。在诊断为巨大肺间质性肿瘤后,她在体外膜肺氧合(ECMO)和高频通气下接受了完整切除,使用硬质支气管镜进行气道管理。ECMO成功撤离,3天后气管导管拔除。在4周随访时,她的症状明显缓解,未报告神经或心血管并发症。

结论

这是迄今为止少数几例关于采用ECMO和硬质支气管镜治疗小儿肺间质性肿瘤的详细报告之一。术前多学科合作、ECMO和硬质支气管镜对于成功切除小儿肺间质性肿瘤至关重要,且可能显著改善小儿患者的长期预后。

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