ECMO辅助抢救甲状腺肿瘤压迫颈段气管致窒息1例  

ECMO assisted in the rescue of thyroid tumor pressing the cervical trachea and causing suffocation:a case report

作　　者：田春辉[1,2] 刘业海[1] 汪东[1] 吴静[1] 吴开乐[1] TIAN Chunhui;LIU Yehai;WANG Dong

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥230022 [2]安徽医科大学附属宿州医院耳鼻咽喉科,宿州235200

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第9期842-844,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：安徽省科技攻关计划项目(No:1501041147)。

摘　　要：气管狭窄多为气管外肿瘤压迫、浸润或气管内新生物堵塞引起。轻者会导致患者呼吸不畅,重者导致呼吸困难,甚至发生窒息死亡。巨大肿物导致的气管狭窄对耳鼻咽喉科和麻醉科医师的气道管理水平是一个挑战,在整个围术期需要多学科的紧密沟通和配合[1]。如何尽快安全地解除气道梗阻是治疗成功的关键。随着体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)在临床中的广泛应用,让重度气管狭窄发生窒息的患者得到救治。A 74-year-old woman suffered from asphyxia due to a huge thyroid mass compressing cervical trachea. The patient developed dyspnea, orthopnea, shortness of breath. SpO2 was about 90% under high flow oxygen inhalation. Protuberant mass was seen in the anterior midline of neck. The palpation was hard, the boundary was not clear, and the trachea couldn’t be touched. Neck CT showed a huge mass in the thyroid and severe tracheal compression. And electronic laryngoscopy showed paralysis in bilateral vocal cord, which were fixed in the paramedian position. With the further development of the disease, the patient appeared asphyxia and was in critical condition. After multidisciplinary consultation, considering the high risk of direct intubation, ECMO was used to assist and performed "total thyroidectomy + tracheostomy" under general anesthesia. The patient got successful treatment finally.

关 键 词：甲状腺肿瘤 气管 窒息 

分 类 号：R736.1[医药卫生—肿瘤]