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篇名 |
對一軟骨發育不全性侏儒合併水腦症進行減壓手術之氣道處理
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並列篇名 |
Airway Management of an Achondroplastic Dwarf with Hydrocephalus Undergoing Decompression Surgery |
作者 |
陳嘉雯、鄒美勇、蔡勝國、曹正明 |
中文摘要 |
軟骨發育不全症是造成侏儒病最常見的原因。其神經學的問題為枕骨肥厚引起枕骨大孔狹窄造成水腦症,及第一頸椎異常造成之脊髓壓迫,而枕骨下頭顱切開術是治療的方法。我們報告一個三個月大患有軟骨發育不全症的病例,因枕骨大孔狹窄造成水腦症必須進行枕骨下頭顱切開減壓手術。病人也於恢復室清醒並順利拔管。外科醫師考量到頸椎伸展可能造成脊髓壓迫更嚴重,於是要求我們使用清醒時氣管插管,並於插管後確認病人第一頸椎下的運動功能完好。整個手術過程相當平順,我們同時回顧有關軟骨發育不全症的討論及麻醉時可能面臨到的相關問題。 |
英文摘要 |
The neurological problem of achondroplasia is hydrocephalus which may arise from stenosis of the foramen magnum secondary to occipital hypertrophy. The spine is also affected by abnormalities in the cervical region (odontoid hypoplasia and occipitalization of Q), which can compound the problem of cord compression. We report a rare instance of achondroplasia in a 3-month-old female infant with the risk of spinal cord compression during the manipulation of endotracheal intubation. For fear of that the surgeon inclined awake intubation in order that spinal cord intactness could be confirmed by neurological test on the spot after intubation. Awake oral endotracheal intubation was performed although with some difficulty, yet the motor function at the first cervical spinal level was unmolested as revealed by neurological test after intubation. |
起訖頁 |
169-172 |
關鍵詞 |
開顱手術、水腦、氣管內插管、清醒、Achondroplasia、Craniotomy、Hydrocephalus、Intubation、intratracheal、Wakefulness |
刊名 |
麻醉學雜誌 |
期數 |
200509 (43:3期) |
出版單位 |
台灣麻醉醫學會
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巨大的左心房感染性心內膜炎但未感染瓣膜的心臟超音波表現 |
該期刊-下一篇 |
氣切造口肉芽組織引發急性氣道阻塞之病例報告 |
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