Hitomi K, Maeda L, Taniguchi A, Kawahara R, Kitamura S
Department of Anesthesia and Intensive Care Medicine, Osaka Children's Medical Center.
Masui. 1993 Oct;42(10):1517-20.
Rehbein's method is one of the surgical procedures for pediatric pectus excavatum, which constructs thorax by lifting and fixating the sternum using metal strut inserted into bone marrow of bilateral ribs. We experienced two pediatric cases of tension pneumothorax caused by tracheal suctioning during the operation by this method. The etiology of tension pneumothorax was thought to be as follows. A small pleural hole was made during separation of ribs from surrounding tissues and a large amount of air entered into the pleural space and check valve mechanism worked at the pleural hole when the lung was collapsed on tracheal suctioning. In anesthetic management of pectus excavatum by Rehbein's method, we should always be cautious of the possible occurrence of tension pneumothorax.
雷贝因氏法是小儿漏斗胸的外科手术方法之一，该方法通过将金属支柱插入双侧肋骨骨髓来提升和固定胸骨以构建胸廓。我们遇到了两例在使用该方法进行手术期间因气管吸引导致张力性气胸的儿科病例。张力性气胸的病因被认为如下。在肋骨与周围组织分离过程中形成了一个小的胸膜孔，大量空气进入胸膜腔，并且在气管吸引时肺萎陷时胸膜孔处出现了单向活瓣机制。在采用雷贝因氏法治疗漏斗胸的麻醉管理中，我们应始终警惕可能发生的张力性气胸。
