- 期刊
拔管後因上呼吸道阻塞造成之肺水腫－兩個病例報告
Post-Obstructive Pulmonary Edema Following Extubation-Report of Two Cases
摘要
肺水腫可發生於麻醉的健康正常病人，其中因喉部肌肉痙攣或吸入異物引起之呼吸道阻塞所致肺水腫較常見，這可能是因呼吸道阻塞後病人作深吸氣造成胸內負壓所致。本文提出兩個拔管從病人發生呼吸道阻塞，隨即引發肺水腫的病例，第一病例為健康病人接受泌尿道矯正手術，第二病例為接受肺泡膜切除術之健康病人。手術中他們的血壓及呼吸功能均能維持正常，氣管拔管後引起呼吸道阻塞隨即引起肺水腫，經治療後無大礙。
關鍵字
肺水腫，上呼吸道阻塞：上呼吸道並列摘要
Pulmonary edema may develop in healthy patients after anesthesia. It usually results from upper airway obstruction which may be caused by laryngospasm or aspiration. Increased inspiratory effort following airway obstruction significantly produces negative intrathoracic pressure that may lead to pulmonary edema. We reported two cases of post-obstructive pulmonary edema following extubation. They were essentially healthy young males, one of whom received urethroplasty and the other received pulmonary blebectomy. Their hemodynamic and ventilatory conditions had been kept stable during surgery. Upper airway obstruction followed by pulmonary edema developed immediately after extubation, which was successfully treated without any sequelae.
延伸閱讀
- Chen, I. J., Chen, C. Z., Chu, Y. C., & Hsiue, T. R. (2002). 拔管後之肺水腫：一病例報告. 胸腔醫學, 17(3), 258-263. https://www.airitilibrary.com/Article/Detail?DocID=10239855-200209-17-3-258-263-a
- 陳憶如、吳孝存、徐郁琇、郭寶梅、林聖翔（2018）。【論文摘要】拔管後咽喉水腫合併負壓性肺水腫病人之呼吸照顧經驗。呼吸治療，17(1)，76-76。https://doi.org/10.6269/JRT.201807_17(1).0043
- 陳信傑、康柏皇、林育良、林曜祥（2003）。腺樣體切除及鼻後填塞術後併發急性肺水腫。台灣耳鼻喉頭頸外科雜誌，38(4)，183-187。https://doi.org/10.6286/2003.38.4.183
- Chien, T. C., Tsai, S. H., Hsu, C. W., Chen, S. C., & Chu, S. J. (2007). 急性肺水腫於一上呼吸道阻塞的成人病患. 內科學誌, 18(2), 108-112. https://doi.org/10.6314/JIMT.2007.18(2).07
- Liu, K. T., Su, H. T., Chiu, C. H., & Perng, R. P. (2006). Post-ictal Neurogenic Pulmonary Edema-A Case Report. 胸腔醫學, 21(5), 439-443. https://doi.org/10.29806/TM.200610.0006