頸椎前位手術術後呼吸道壓迫

Airway Compression after Anterior Cervical Spine Surgery

頸椎前位手術是脊椎骨科常見的手術，術後呼吸道壓迫是可能發生的併發症，若不妥善處理，病患可能因呼吸窘迫而危及生命。術中硬腦膜撕裂導致腦脊髓液滲漏，是發生率較少的併發症，甚至很少會導致呼吸窘迫。本文介紹1位72歲男性，因為脊椎後縱韌帶鈣化接受頸椎前位減壓手術，術後發生腦脊髓液滲漏壓迫食道氣管，造成嚴重氣管壓迫。由於此個案並無明顯喘或血氧濃度的變化，臨床不容易被察覺，透過此案的照顧過程，除了分享治療腦脊髓液滲漏的治療經驗，醫護同仁在照顧頸椎手術術後的病人，能早期辨識呼吸道壓迫的徵象，可避免病房緊急插管的事件發生。

Anterior cervical spine surgery is a common surgery in orthopedics spine surgery. Postoperative airway compression is a possible complication. If not handled properly, patients may suffer from respiratory distress and be life-threatening. Intraoperative dural tear leading to cerebrospinal fluid leakage is a rare complication and rarely even causes respiratory distress. This article introduces a 72-year-old man who underwent anterior cervical decompression surgery due to calcification of the posterior longitudinal ligament of his spine. After the operation, cerebrospinal fluid leakage occurred and compressed the esophagus and trachea, causing severe tracheal compression. Since there was no obvious wheezing or changes in blood oxygen concentration in this case, it was not easy to detect clinically. Through the care process of this case, in addition to sharing the treatment experience of treating cerebrospinal fluid leakage, medical colleagues also took care of patients after cervical spine surgery. Detect signs of respiratory compression early to avoid emergency intubation in the ward.