留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

1例重度肺功能不全患者脊柱侧凸矫形术的围手术期麻醉管理

朱徐锐 郝静 张伟 董媛媛 顾小萍

朱徐锐, 郝静, 张伟, 董媛媛, 顾小萍. 1例重度肺功能不全患者脊柱侧凸矫形术的围手术期麻醉管理[J]. 中华全科医学, 2025, 23(1): 172-174. doi: 10.16766/j.cnki.issn.1674-4152.003860
引用本文: 朱徐锐, 郝静, 张伟, 董媛媛, 顾小萍. 1例重度肺功能不全患者脊柱侧凸矫形术的围手术期麻醉管理[J]. 中华全科医学, 2025, 23(1): 172-174. doi: 10.16766/j.cnki.issn.1674-4152.003860
ZHU Xurui, HAO Jing, ZHANG Wei, DONG Yuanyuan, GU Xiaoping. Perioperative anesthesia management for scoliosis correction in a patient with severe pulmonary insufficiency: a case report[J]. Chinese Journal of General Practice, 2025, 23(1): 172-174. doi: 10.16766/j.cnki.issn.1674-4152.003860
Citation: ZHU Xurui, HAO Jing, ZHANG Wei, DONG Yuanyuan, GU Xiaoping. Perioperative anesthesia management for scoliosis correction in a patient with severe pulmonary insufficiency: a case report[J]. Chinese Journal of General Practice, 2025, 23(1): 172-174. doi: 10.16766/j.cnki.issn.1674-4152.003860

1例重度肺功能不全患者脊柱侧凸矫形术的围手术期麻醉管理

doi: 10.16766/j.cnki.issn.1674-4152.003860
基金项目: 

国家自然科学基金项目 81730033

国家自然科学基金项目 82171193

详细信息
    通讯作者:

    顾小萍,E-mail:xiaopinggu@nju.edu.cn

  • 中图分类号: R681.5 R614.2

Perioperative anesthesia management for scoliosis correction in a patient with severe pulmonary insufficiency: a case report

  • 摘要: 脊柱侧凸合并胸廓畸形患者往往肺功能受到严重损伤,给手术麻醉带来极高的风险,脊柱矫形手术后近期肺功能会进一步下降,因此,围手术期选择合适的手术麻醉策略对保护患者肺功能十分重要。本文报道1例脊柱侧凸术前伴有严重的混合性通气功能障碍患者围手术期的麻醉管理。

     

  • 图  1  立位全脊柱正位片

    注:左(术前),右(术后)。

    Figure  1.  Standing spinal x-rays

    图  2  术前胸部CT

    Figure  2.  Preoperative chest CT

  • [1] NEGRINI S, DONZELLI S, AULISAA G, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J]. Scoliosis Spinal Disord, 2018, 13: 3. DOI: 10.1186/s13013-017-0145-8.
    [2] KAYA M H, ERBAHÇECI F, ALKAN H, et al. Factors influencing of quality of life in adolescent idiopathic scoliosis[J]. Musculoskelet Sci Pract, 2022, 62: 102628. DOI: 10.1016/j.msksp.2022.102628.
    [3] KAN M M P, NEGRINI S, DI FELICE F, et al. Is impaired lung function related to spinal deformities in patients with adolescent idiopathic scoliosis? A systematic review and meta-analysis SOSORT 2019 award paper[J]. Eur Spine J, 2023, 32(1): 118-139. doi: 10.1007/s00586-022-07371-z
    [4] YUAN N, FRAIRE J A, MARGETIS M M, et al. The effect of scoliosis surgery on lung function in the immediate postoperative period[J]. Spine (Phila Pa 1976), 2005, 30(19): 2182-2185. doi: 10.1097/01.brs.0000181060.49993.4a
    [5] ZHOU X, ZHANG Z, YANG Y, et al. Pulmonary recovery following corrective surgery in adult patients with severe scoliosis: a minimum of five-year follow-up[J]. Front Med (Lausanne), 2022, 9: 915904. DOI: 10.3389/fmed.2022.915904.
    [6] YASZAY B, JANKOWSKI P P, BASTROM T P, et al. Progressive decline in pulmonary function 5 years post-operatively in patients who underwent anterior instrumentation for surgical correction of adolescent idiopathic scoliosis[J]. Eur Spine J, 2019, 28(6): 1322-1330. doi: 10.1007/s00586-019-05923-4
    [7] 中华医学会麻醉学分会"围术期肺保护性通气策略临床应用专家共识"工作小组. 围术期肺保护性通气策略临床应用专家共识[J]. 中华麻醉学杂志, 2020, 40(5): 513-519. doi: 10.3760/cma.j.cn131073.20200402.00501

    Working group of "Expert Consensus on Clinical Application of perioperative lung protective Ventilation Strategy", Chinese Society of Anesthesiology. Expert consensus on clinical application of perioperative lung-protective ventilation strategies[J]. Chinese Journal of Anesthesiology, 2020, 40(5): 513-519. doi: 10.3760/cma.j.cn131073.20200402.00501
    [8] 于洋, 姚媛媛, 明月, 等. 脊柱侧弯矫形手术患者术后肺部并发症的危险因素[J]. 临床麻醉学杂志, 2022, 38(10): 1071-1075. doi: 10.12089/jca.2022.10.012

    YU Y, YAO Y Y, MING Y, et al. Risk factors of postoperative pulmonary complications in patients undergoing scoliosis fusion surgery[J]. Journal of Clinical Anesthesiology, 2022, 38(10): 1071-1075. doi: 10.12089/jca.2022.10.012
    [9] BASBUG G, GURSES H N, ZEREN M, et al. Effects of inspiratory muscle training on respiratory muscle strength, respiratory function and functional capacity in adolescents with idiopathic scoliosis: a randomized, controlled trial[J]. Wien Klin Wochenschr, 2023, 135(11-12): 282-290. doi: 10.1007/s00508-023-02197-1
    [10] FELDMAN J M. Optimal ventilation of the anesthetized pediatric patient[J]. Anesth Analg, 2015, 120(1): 165-175. doi: 10.1213/ANE.0000000000000472
    [11] 霍良红, 胡璟, 张建敏. 肺保护性通气策略对脊柱侧弯矫形术患儿术后肺部并发症的影响: 基于倾向性评分匹配的回顾性队列研究[J]. 中华麻醉学杂志, 2020, 40(6): 646-650. doi: 10.3760/cma.j.cn131073.20191011.00602

    HUO L H, HU J, ZHANG J M. Effect of lung-protective ventilation strategy on postoperative pulmonary complications in pediatric patients undergoing scoliosis surgery: a retrospective propensity score-matched cohort study[J]. Chinese Journal of Anesthesiology, 2020, 40(6): 646-650. doi: 10.3760/cma.j.cn131073.20191011.00602
    [12] DE JONG A, WRIGGE H, HEDENSTIERNA G, et al. How to ventilate obese patients in the ICU[J]. Intensive Care Med, 2020, 4(12): 2423-2435.
    [13] BALL L, BOS L D, PELOSI P. High-flow nasal cannula in the postoperative period: is positive pressure the phantom of the OPERA trial?[J]. Intensive Care Med, 2017, 43(1): 119-121. doi: 10.1007/s00134-016-4627-6
    [14] ZHU Y, YIN H, ZHANG R, et al. High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis[J]. Crit Care, 2019, 23(1): 180. doi: 10.1186/s13054-019-2465-y
    [15] RAMNARAYAN P, RICHARDS-BELLE A, DRIKITE L, et al. Effect of high-flow nasal cannula therapy vs continuous positive airway pressure therapy on liberation from respiratory support in acutely ill children admitted to pediatric critical care units: a randomized clinical trial[J]. JAMA, 2022, 328(2): 162-172.
    [16] TSENG C W, CHAO K Y, WU H L, et al. Effectiveness of high-flow nasal cannulae compared with noninvasive positive-pressure ventilation in preventing reintubation in patients receiving prolonged mechanical ventilation[J]. Sci Rep, 2023, 13(1): 4689. DOI: 10.1038/s41598-023-31444-8.
  • 加载中
图(2)
计量
  • 文章访问数:  26
  • HTML全文浏览量:  13
  • PDF下载量:  1
  • 被引次数: 0
出版历程
  • 收稿日期:  2024-06-11
  • 网络出版日期:  2025-02-13

目录

    /

    返回文章
    返回