Braun R, Jahn U R, Schumacher W, Lang R, Thiele H
Allgemeine Anästhesieabteilung, Kreiskrankenhaus Bruchsal.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1994 Aug;29(5):302-3. doi: 10.1055/s-2007-996747.
This case report deals with pneumothorax during elective laparoscopic cholecystectomy in a young woman with no history of severe pulmonary disease. After inflating the capnoperitoneum, pulse oximetry and capnography raised suspicion of pneumothorax whereas the physical examination showed no irregularities. Surgical drapes provided a lack of information from percussion and auscultation. Changing respiratory parameters including the use of pressure-controlled ventilation in absence of tension pneumothorax enabled sufficient ventilation until the insertion of a chest tube. There were no further postoperative complications. Pulse oximetry, capnography and relaxometry proved helpful in monitoring. There may be a benefit from the use of pressure-controlled-ventilation in certain situations, if all changes in volume-controlled-ventilation fail.
本病例报告涉及一名无严重肺部疾病史的年轻女性在择期腹腔镜胆囊切除术期间发生的气胸。在气腹充气后，脉搏血氧饱和度测定和二氧化碳描记法引发了对气胸的怀疑，而体格检查未发现异常。手术巾妨碍了叩诊和听诊获取信息。在无张力性气胸的情况下改变呼吸参数，包括使用压力控制通气，可实现充分通气，直至插入胸管。术后无进一步并发症。脉搏血氧饱和度测定、二氧化碳描记法和松弛测定法在监测中被证明是有用的。如果容量控制通气的所有改变均无效，在某些情况下使用压力控制通气可能有益。
