- 期刊
氣管雷射手術後併發心包膜積氣-病例報告
Pneumopericardium Following Tracheal Laser Surgery-Case Report
摘要
對於氣管狹窄的病患，我們經常讓病患在高頻率噴式換氣(high-frequency jet ventilation)麻醉下，經由硬式支氣管鏡合併銣雅克雷射(Nd: YAG lacer)進行手術。此種手術可能之併發症包括了換氣不足、氣道著火、術後出血、氣胸、縱膈腔積氣、皮下氣腫等。本院經歷1名11個月大法洛式四重症(Tetralogy of Fallot)合併氣管狹窄之女嬰，我們不安排讓病患在高頻率噴氣式換氣麻醉下，接受氣管雷射手術。病患之術後胸部x光檢查，呈現有心包膜積氣之現象，因病患生命徵象並無明顯變化，遂經密切觀察並於隔日追蹤胸部x光檢查，結果發現心包膜積氣已自動吸收。因為此一併發症極為罕見，故提出此病例之臨床病程及治療方法，並討論其可能之致病機轉。(
並列摘要
Tracheal stenosis is frequently treated with Nd:YAG laser which is performed via a rigid bronchoscope under general anesthesia using high-frequency jet ventilation. Possible complications of the surgery include hypoventilation, postoperative hemorrhage, pneumothorax, pneumomediastinum, and subcutaneous emphysema. In this paper we reported an eleven-month-old female infant who had suffered from Tetralogy of Fallot and tracheal stenosis. Under general anesthesia and high-frequency jet ventilation, laser surgery for the tracheal stenosis was performed. Postoperative chest X-ray revealed a moderate-degree pneumopericardium, but significant changes in vital signs were not seen. Policy of conservative treatment was adapted. Fortunately, the pneumopericardium, resolved spontaneously the next day. We present the clinical course and therapeutic outcome of this patient and discuss the possible etiology.
延伸閱讀
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