气管内巨大肿物伴气道极重度狭窄麻醉管理一例

A Case of Anesthesia Management of a Huge Endotracheal Mass with Very Severe Airway Stenosis

摘要: 患者，女，51岁，160 cm，53 kg，ASA III级。因“呼吸困难4天入院”。患者8个月前于外院行“右侧甲状腺癌根治术 + 右侧颈部淋巴结清扫术”，2个月前于我院行“左侧甲状腺级峡部全部切除术 + 右侧颈部探查术 + 右侧颈部肿块及甲状腺切除术 + 右侧颈侧区淋巴结清扫术”，现拟在全身麻醉下行“气管镜下沙漏型硅酮支架置入术”。患者现不能平卧，端坐呼吸，静息性呼吸困难，肺部听诊有喘鸣，可见明显的三凹征，未见发绀。既往无高血压、糖尿病、心脏病等。

Abstract: Patient, female, 51 years old, 160 cm, 53 kg, ASA III. She was admitted to the hospital with “dyspnea for 4 days”. The patient underwent “radical surgery for right-sided thyroid cancer + right-sided neck lymph node dissection” in a foreign hospital 8 months ago, and “total resection of the left isthmus of the thyroid gland + right-sided neck exploration + right-sided neck mass and thyroidectomy + right-sided cervical lymph node dissection” in our hospital 2 months ago. Under general anesthesia, the patient is to undergo tracheoscopic hourglass silicone stenting. The patient was unable to lie down, sit and breath, with resting dyspnea, wheezing on lung auscultation, obvious triple concave signs, and no cyanosis. There was no previous hypertension, diabetes mellitus or heart disease.