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[纵隔恶性淋巴瘤病例麻醉期间的呼吸阻塞]

[Respiratory obstruction during anesthesia in cases of mediastinal malignant lymphoma].

作者信息

Monleau M, Alibeu J P, Stieglitz P, Sotto J J, Dyon J F

出版信息

Ann Fr Anesth Reanim. 1983;2(4):308-11. doi: 10.1016/s0750-7658(83)80029-x.

Abstract

Three cases of asphyxia at the beginning of general anaesthesia for mediastinoscopy or biopsy of adenopathy are described in patients with malignant lymphoma. One of them died in spite of endobronchial intubation, artificial ventilation and steroids. The two others recovered when specific chemotherapy was added to the same symptomatic treatment. The risk of respiratory obstruction seems higher in non-Hodgkin than in Hodgkin lymphomas. This kind of obstruction is not relieved by an antiasthmatic therapy. Pulmonary lymphatic filtration may be hindered in case of mediastinal lymphoma, especially during anaesthetic induction, and pulmonary interstitial congestion may occur impeding gas propagation. Specific chemotherapy according to the histological type of the tumour may relieve the compression and respiratory obstruction in a few hours.

摘要

本文描述了3例恶性淋巴瘤患者在纵隔镜检查或淋巴结活检全身麻醉开始时发生窒息的情况。其中1例尽管进行了支气管内插管、人工通气并使用了类固醇,但仍死亡。另外2例在相同的对症治疗基础上加用特异性化疗后康复。非霍奇金淋巴瘤患者发生呼吸阻塞的风险似乎高于霍奇金淋巴瘤。这种阻塞不能通过抗哮喘治疗缓解。纵隔淋巴瘤患者可能会出现肺淋巴滤过受阻,尤其是在麻醉诱导期间,并且可能会发生肺间质充血,阻碍气体传播。根据肿瘤的组织学类型进行特异性化疗可能在数小时内缓解压迫和呼吸阻塞。

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