擴張因雙側巨大甲狀腺腫造成氣管壓迫的簡易方法

A Simple Method for Dilatation of the Trachea Compressed by Large Bilateral Goiter

我們描述了一位63歲女性因雙側巨大甲狀腺腫造成氣管偏移和壓迫的麻醉處置。病患因氣管受甲狀腺腫壓迫造成呼吸窘迫而需行甲狀腺切除術。我們在建立葉克膜後進行麻醉誘導，然後以較小尺寸的氣管內管進行氣管插管，再以氣管內管的氣囊對氣管狹窄處進行擴張，並依次更換較大尺寸的氣管內管並以氣囊擴張氣管狹窄處。葉克膜在7毫米氣管內管成功置放後停止，施行甲狀腺切除術時因沒有抗凝劑的影響，出血量並不多。

The anesthetic management of a 63-year-old woman with a large bilateral thyroid goiter causing tracheal deviation and compression was described. Thyroidectomy was planned for severe airway compromise. Extracorporeal membrane oxygenation (ECMO) was established before anesthesia induction. The trachea was intubated, beginning with a small cuffed endotracheal tube that was inflated and sequentially replaced with larger tubes until a 7-mm tube was placed to dilate the trachea successfully. ECMO was discontinued after the airway was established. There was minimal bleeding during thyroidectomy.