先天性紫绀型心脏畸形患者急诊手术的麻醉管理:病例报告

IF 1.3 Q3 ANESTHESIOLOGY
H. Pahuja, Ravikiran Nikhade, Anjali Bhure, A. Pingley
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引用次数: 0

摘要

在先天性紫绀型心脏病(CHD)中,伴有大血管转位和室间隔缺损(VSD)的全坐位综合征的发病率非常低,约为万分之一。在此,我们介绍一名患有上述心脏畸形、心律失常、脓毒性休克的 16 岁男性患者,他曾因交通事故引发左大腿骨髓炎,需要切开引流。患者因高烧、脉压窄和心房颤动被送入重症监护室。患者在全身麻醉下接受了手术,优化后进行了气管插管。术中需要进行有创监测、使用抗心律失常药物和血管加压药,手术进展顺利。此外,患者还在 8 天后进行了一系列清创手术,这些手术都是在区域麻醉下顺利进行的。本病例报告体现了围手术期麻醉管理的行动计划,并预示了心脏疾病患者在手术过程中可能遇到的困难以及后续的谨慎措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anesthetic management of a patient with congenital cyanotic heart anomaly for emergency surgery: A case report
Among congenital cyanotic heart diseases (CHDs), situs inversus totalis with transposition of great vessels with a large ventricular septal defect (VSD) has a very low incidence of around 1 in 10,000. Hereby, we present a 16-year-old man with the aforementioned cardiac anomaly with cardiac arrhythmias, septic shock, and a history of road traffic accident-causing osteomyelitis of the left thigh requiring incision and drainage. The patient was admitted to the intensive care unit with a high-grade fever, narrow pulse pressure, and atrial fibrillation. The patient was operated on under general anesthesia with endotracheal intubation after optimization. Invasive monitoring, antiarrhythmics, and vasopressors were required intraoperatively, and surgery progressed uneventfully. Furthermore, the patient had undergone a series of debridements after 8 days, which were performed under regional anesthesia uneventfully. This case report represents a plan of action for perioperative anesthetic management and anticipates the difficulties for CHD patients in the course of surgery and subsequential prudence.
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来源期刊
CiteScore
1.90
自引率
8.30%
发文量
141
审稿时长
36 weeks
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