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1、·744·史國刨壁盤查—第14卷第8期ChinJMinInvSurg,August2014,Vo1.14.No.8短篇論著·氟骨癥性頸椎管狹窄癥手術的麻醉管理劉偉平韓永正張耕張梁王軍郭向陽(北京大學第三醫(yī)院麻醉科,北京100191)【摘要】目的探討氟骨癥性頸椎管狹窄癥手術的麻醉特點及管理方法。方法對2009年2月2014年3月5例氟骨癥性頸椎管狹窄癥的麻醉管理進行總結(jié)。2例術前頸椎活動嚴重受限,改良Mallampati分級Ⅲ級,考慮可能為困難氣管插管,清醒表面麻醉下行纖維支氣管鏡引導氣管插管;余3例為非困難氣管插管,行快速誘導直視下Macintosh喉鏡氣管插管。結(jié)
2、果5例均安全度過圍術期,無死亡。1例因呼吸功能不全,術后轉(zhuǎn)入ICU病房,次日拔管;余4例術后轉(zhuǎn)入PACU拔管。術后均無麻醉相關并發(fā)癥,順利出院。結(jié)論氟骨癥性頸椎管狹窄癥患者困難氣道發(fā)生率高,氣道管理是圍術期麻醉管理的核心問題?!娟P鍵詞】氟骨癥性頸椎管狹窄癥;麻醉管理;困難氣道中圖分類號:R614.2文獻標識:A文章編號:1009—6604(2014)08—0744—03doi:10.3969/j.issn.1009—6604.2014.08.023AnestheticManagementforFluorosisCervicalStenosisOperationsLi
3、uWe~ing,HanYongzheng,ZhangGeng,eta1.DepartmentofAnesthesiology,PekingUniversityThirdHospital,Beijing100191,ChinaCorrespondingauthor:ZhangGeng,E—mail:zg1999@sohu.con【Abstract】ObjectiveToexploretheanestheticmanagementduringoperationforfluorosiscervicalstenosis.MethodsThedemographicdata,s
4、urgicalparameters,andanestheticmanagementof5patientswithfluorosiscervicalstenosisfromFebruary2009toMarch2014wereanalyzed.Twoofthe5patientshadseverelylimitedmovementofcervicalspineandwereclassifiedasMallampatigradeIH.Bothofthemreceivedawakefiberopticintubationundertopicalanesthesia.Ther
5、emainingthreepatientshadn0difficultyintrachealintubationandwereintnbatedwithMacintoshdirectlaryngoscopeunderrapidanesthesiainduction.ResultsAllthepatientsunderwentthesurgerysmoothly,withoutdeathsduringtheperioperativeperiod.Aftersurgery,1patientwastransferredtotheICUduetorespiratoryins
6、uficiencyandwasextubatedonthefollowingday.Theremaining4patientsweretransferedtothePACUandhadthetrachealtuberemovedthereafterwards.Allthepatientshadnoanesthesiarelatedcomplicationsafteroperationandweredischargeduneventfully.ConclusionsPatientswithfluorosiscervicalstenosishaveahighincide
7、nceofdificultairway.Airwaymanagementisthekeyofperioperativeanestheticmanagement.【KeyWords】Fluorosiscervicalstenosis;Anestheticmanagement;Dificultairway氟骨癥是指長期攝人過量氟化物引起氟中毒(46.24-14.1)歲,體重指數(shù)19.56—33.21,23.91±并累及骨組織的一種慢性侵襲性全身性骨病?,5.68。3例下肢行走困難,胸腹部束帶感,2例上肢中重度患者以侵犯脊柱多見,氟化物使黃韌帶骨肌力減退、肌肉萎縮,表