查詢結果分析
來源資料
相關文獻
- Difficult Airway Management for VATS Surgery: A Case Report
- 拔牙後併發破傷風--病例報告
- 以高位邊緣性骨切除術合併咀嚼肌群剝離術治療頰黏膜癌導致之張口受限--病例報告
- 會陰癌合併牙關緊閉之個案報告
- Combined Nasolabial Flap and Z-Plasty for Trismus Release and Mouth Angle Reconstruction--A Report of Two Cases and Literature Review
- Case Report: Masticatory Muscle Myositis in a Dog
- All-on-4立即負荷植牙於輕度牙關緊閉病患植體追蹤短期報告
- An Experience in Treating Generalized Tetanus: A Case Report
- Surgical Approach of Trismus Caused by Oral Submucous Fibrosis and Evaluation of Buccal Mucosal Elasticity
- 探討張口受限患者的牙關緊閉與生活品質之關係
頁籤選單縮合
題名 | Difficult Airway Management for VATS Surgery: A Case Report=困難插管病患接受胸腔內視鏡雙肺肺葉切除手術之病例報告 |
---|---|
作者姓名(中文) | 張家昇; 陳克章; 陳坤堡; 涂坤村; 鄭鴻鈞; 黃信哲; | 書刊名 | 中國醫藥雜誌 |
卷期 | 2:4 1997.12[民86.12] |
頁次 | 頁244-248 |
分類號 | 416.224 |
關鍵詞 | 單肺麻醉法; 支氣管阻塞球; Fogarty靜脈導管; 牙關緊閉; One-lung anesthesia; Bronchial blocker; Fogarty catheter; Trismus; |
語文 | 英文(English) |
中文摘要 | 對肺部手術實施單肺換氣法之麻醉技術非常有助手術的進行,是胸腔外科手術麻醉中一項重要技術。我們常使用經口雙管腔氣管內管插管來達成此目標,但是在一些病患無法使用此技術,例如在牙關緊閉的病患。而替代雙管腔氣管內管的設備如高頻率噴器換氣(high frequency jet ventilation)或深度足夠的單管(univent bronchial blocker ube)並非一般醫院皆有之設備,而且更伴隨著氣體壓力傷害之可能性,若做氣管造口術來插管其侵襲傷害性接非此時所願。肺支氣管阻塞技術亦是另一種替代方式,在此我們報告一位因嚼檳榔而牙關錦弊病患接受雙肺上夜切除手術之麻醉。肺上葉切除手術麻醉本身即為一種複雜手術之麻醉,因為須將氣管及肺上支氣管隔絕,在如此短肢解剖距離調整栓塞球位置更屬高難度之處理,而現今文獻更尚無同時進行雙肺上葉交替隔絕之手術麻醉報告。在本文中我們探討使用靜脈栓塞切除用之Fogarty導管來完成此麻醉的成功經驗,以及使用此技術時遭遇之各種情況的探討報告。 |
英文摘要 | One lung ventilation is an important technique for thoracic surgery. Double lumen endotracheal tube usually applies for this purpose. In some cases, it is difficult or impossible to place the double lumen endotracheal tube. Alternative instruments, such as a high frequency jet ventilation or univent tube, are not available in most local hospitals and also carry dangerous barotrauma risk. We report a trismic victim who received bilateral pulmonary apical segmentation with video assisted thoracoscopic surgery (VATS). In this case, it was impossible to place the double lumen endotracheal tube either by mouth or by nasal route. Inserting a Fogarty venous embolectomy catheter to desired bronchi enabled one lung anesthesia performed without disturbing the surgery. We should consider this technique before abandoning intubation in those few cases where double lumen endotracheal tubes fail to be placed as desired. Bilateral apical segmentation is much different from single lung surgery. We devoted the experiences of alternating placement of blocker to isolate both apical segment and the management of lethal event such as the cuff herniation and hypoxemia. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。