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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Post- Thyroidectomy HaematomaCausing Severe Supraglottic Oedema andPulmonary Oedema - A Case Report
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Post- Thyroidectomy HaematomaCausing Severe Supraglottic Oedema andPulmonary Oedema - A Case Report

机译：甲状腺切除术后血肿引起严重的声门上水肿和肺水肿-病例报告

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摘要

Large, long standing goiters present multiple challenges to anaesthesiologist. Post thyroidectomy haematoma is a rare but life threatening complication of thyroid surgery leading to airway obstruction. We report a case of huge goiter that underwent near total thyroidectomy and developed post thyroidectomy haematoma. Within no time it resulted in near fatal airway obstruction, pulmonary oedema and cardiac arrest. The haematoma was evacuated immediately and patient was resuscitated successfully. Pulmonary oedema was further worsened by subsequent aggressive fluid resuscitation. She was electively ventilated with PEEP and was extubated after five days. Except for right vocal cord palsy her postoperative stay was uneventful. This is unique case where a post thyoidectomy haematoma has resulted in fatal supraglottic oedema and pulmonary oedema. Early recognition, immediate intubation and evacuation of haematoma are the key to manage this complication. We highlight on the pathophysiology of haematoma and discuss the strategies to prevent similar events in future.
机译：大型，长期站立的甲状腺肿给麻醉师带来了多重挑战。甲状腺切除术后血肿是一种罕见但危及生命的并发症，会导致气道阻塞。我们报告了一个巨大的甲状腺肿，该甲状腺肿在全甲状腺切除术附近发生，并在甲状腺切除术后发生血肿。在短时间内，它会导致致命的气道阻塞，肺水肿和心脏骤停。血肿立即撤离，患者得以成功复苏。后续积极的液体复苏进一步加剧了肺水肿。给她选择PEEP换气，五天后拔管。除右声带麻痹外，她的术后住院时间很顺利。这是甲状腺切除术后血肿导致致命的声门上水肿和肺水肿的独特案例。尽早发现，立即气管插管和清除血肿是控制这种并发症的关键。我们重点介绍血肿的病理生理学，并讨论将来预防类似事件的策略。

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