气管食管瘘患者体外膜式氧合支持下行气管支架置换术麻醉管理1例  

Anesthetic management of tracheoesophageal fistula patients undergoing tracheal stent replacement supported with extracorporeal membrane oxygenation:a case report

作　　者：陈芳 曲鸣宇 钟河江 Chen Fang;Qu Mingyu;Zhong Hejiang(Department of Anesthesiology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China;Department of Anesthesiology,the Second People's Hospital of Jiulongpo District of Chongqing,Chongqing 400052,China)

机构地区：[1]陆军军医大学新桥医院麻醉科,重庆400037 [2]重庆市九龙坡区第二人民医院麻醉科,重庆400052

出　　处：《国际麻醉学与复苏杂志》2022年第6期625-629,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：气管食管瘘(tracheoesophageal fistula, TEF)患者在硬质支气管镜下进行手术,由于麻醉医师和手术医师共用气道,术中通气与氧合的管理是主要挑战。此例TEF患者经超声雾化吸入表面麻醉、超声引导下行双侧喉上神经阻滞,在保留自主呼吸的静脉全身麻醉下,同时在静脉-静脉体外膜式氧合技术辅助下,经硬质支气管镜行气管支架置换术。患者术中氧合良好,平稳完成手术,顺利出院。Patients with tracheoesophageal fistula(TEF)usually undergo surgery through rigid bronchoscopy.As anesthesiologists and surgeons frequently share the airway,management of intraoperative ventilation and oxygenation becomes a major challenge.In the present report,the TEF patient underwent ultrasound atomized inhalation superficial anesthesia,ultrasound-guided bilateral superior laryngeal nerve block,while tracheal stent replacement was performed by rigid bronchoscopy under intravenous general anesthesia with spontaneous breathing and supported with veno-venous extracorporeal membrane oxygenation.The patient had good intraoperative oxygenation,and the whole operation was completed smoothly.The patient was successfully discharged.

关 键 词：气管食管瘘 体外膜式氧合 喉上神经阻滞 麻醉管理 气管支架 

分 类 号：R614[医药卫生—麻醉学]