新生儿巨大先天性肺气道畸形行肺叶切除术的麻醉处理1例  

Anesthetic management of a neonate with congenital pulmonary airway malformation:A case report

作　　者：李友祯 杜彬[3] 林雪梅 Li Youzhen;Du Bin;Lin Xuemei(Department of Anesthesiology,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Chengdu 610041,China;Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院麻醉科,成都610041 [2]四川大学出生缺陷和相关妇儿疾病教育部重点实验室,成都610041 [3]四川大学华西医院麻醉科,成都610041

出　　处：《国际麻醉学与复苏杂志》2023年第2期183-186,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：先天性肺气道畸形(congenital pulmonary airway malformation,CPAM)是先天性肺发育畸形的一种,其中巨大气囊腔畸形较为罕见,常表现为出生后呼吸窘迫、反复感染和气胸等,给新生儿的生存带来极大威胁。文章报道了1例新生儿巨大CPAM行开胸肺叶切除术的麻醉处理方法,此类患儿行手术治疗时,需要肺隔离以保护健侧肺并提供良好的术野暴露。由于新生儿气道的生理特点,可应用的单肺通气策略有限,且由于常并发其他器官畸形,患儿手术耐受力较差,对麻醉医师提出了更高要求。Congenital pulmonary airway malformation(CPAM)is one of the rare developmental lung malformations.Huge cystic lesions are rare and usually characterized by respiratory distress,repeated pulmonary infections and pneumothorax,posing a great threat to the survival of neonates.This article reported the anesthetic management for a neonate who was diagnosed with CPAM and underwent thoracotomy lobectomy.During the surgery,it is necessary to conduct lung isolation,so as to facilitate the exposure of the surgical field and protect the contralateral lung.However,considering the physical characteristics of neonate airway,the strategies for lung isolation are limited.Furthermore,CPAM Neonates also have multiple-organ malformations,and feature poor surgical tolerance,posing challenge for anesthesiologists.

关 键 词：先天性肺气道畸形 单肺通气 小儿 

分 类 号：R726.1[医药卫生—儿科]