强直性脊柱炎患者的纤维插管治疗

C RaghuK, R. Nagesh, K ViswashG
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摘要

背景:强直性脊柱炎是一种慢性炎症性疾病,其特征是脊柱炎症和脊柱关节炎,具有复杂的多基因病因。该病在年轻男性中更为常见,危险因素包括遗传和环境因素。强直性脊柱炎的麻醉管理是一个挑战,因为管理困难的气道、呼吸和心血管并发症,以及疾病和疼痛控制的药物。气道管理和轴向通路可能都是困难的。清醒纤维插管是这些有潜在气道困难的患者最安全的选择(²),因为它可以在实现气道困难的同时进行连续的神经监测。方法:这是一项前瞻性随机双盲研究,在Sri Sathya Sai高等医学研究所进行;70例患者(A - 35组,A - 35组)。所有纳入的受试者经知情同意后,采集所有受试者的血样和尿样。采用实验室标准方法测定血红蛋白、红细胞、白细胞和血小板。对于40岁以上的患者,还需要胸片和心电图检查。结果:本研究评估了在强直性脊柱炎病例中,大多数医生倾向于给予全身麻醉,因为防止脊髓损伤,但在这些病例中,脊柱和周围组织也会涉及到维持患者的气道,这对医生来说是一个挑战,使用纤维插管是接近和维持强直性患者气道的好方法。结论:本研究提示强直性脊柱炎患者术中采用纤维插管代替气管插管是维持患者气道的最佳方法,并可预防脊髓损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fibreoptic intubation in ankylosing spondylitis patients
Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.
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