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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Anaesthetic Management of a Patient with Giant Pulmonary Bullae for Surgical Resection of Carcinoma Upper Alveolus: A Case Report
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Anaesthetic Management of a Patient with Giant Pulmonary Bullae for Surgical Resection of Carcinoma Upper Alveolus: A Case Report

机译：巨肺大疱患者癌上肺泡手术切除的麻醉管理：一例报告

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Patients with incidental bullous lesion of lung occasionally present for non-thoracic surgeries, these patients are at increasedrisk of potential complications which can arise due to bullae, during perioperative period. Anaesthetic management of thesepatients planned for a major non-lung volume reduction surgery is challenging as it is rare and requires careful understandingof anatomical and pathophysiological variation of disease. Safe conduct of anaesthesia can be delivered without isolation ofthe lung or sub-segment in which bulla is involved in these patients so that perioperative respiratory crippling conditions likepneumothorax, emphysema, atelectasis of the surrounding lung parenchyma leading to postoperative respiratory failure canbe avoided. Eternal vigilance, monitoring, ventilator strategies are required to avoid possible perioperative complications anda successful outcome, few essential precautionary measures to be taken include vigilant monitoring of patient perioperatively,avoidance of nitrous oxide, low airway pressures, immediate availability of chest drains, periodic auscultation of chest, arterialblood gas analysis. Here, the present authors report a successful perioperative anaesthetic management of a patient with giantbulla in left upper lobe and right upper lobe developed as post tubercular sequelae that underwent inferior partial maxillectomy withneck dissection and reconstruction for carcinoma upper alveolus without isolation of lung.
机译：偶尔有非胸腔外科手术伴有肺部大疱性病变的患者，这些患者在围手术期中由于大疱引起的潜在并发症风险增加。计划进行大型非肺减容手术的这些患者的麻醉管理极具挑战性，因为这种治疗很少见，需要仔细了解疾病的解剖学和病理生理学变异。可以安全地进行麻醉，而无需隔离这些患者所累及的肺或亚段，从而可以避免围手术期出现呼吸衰竭，例如气胸，肺气肿，周围肺实质的肺不张导致术后呼吸衰竭。为避免可能的围手术期并发症和成功的结局，需要永恒的警惕，监测，呼吸机策略，很少采取必要的预防措施，包括围手术期的患者警惕性监测，避免一氧化二氮，低气道压力，立即进行胸腔引流，定期听诊胸部，动脉血气分析。在这里，本作者报告了一个成功的围手术期麻醉治疗，该患者在左上叶和右上叶巨球形成为结核后后遗症，接受了下颌上部分切除术并进行了颈淋巴结清扫术，并重建了癌上牙槽而未分离出肺。

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