1例贲门失迟缓症患者麻醉中反流误吸及管理

Case Report of Reflux Aspiration and Management during Anesthesia in a Patient with Esophageal Achalasia

摘要: 贲门失迟缓症作为一种罕见病(每10万人中仅约1人)，其主要特征是贲门括约肌的功能障碍导致食物通过食管困难。反流误吸是贲门失迟缓症患者常见的并发症之一，可能导致严重的呼吸系统并发症。本报告探讨了一名贲门失迟缓症患者，在麻醉过程中发生反流误吸的情况。针对误吸反流物的特性，采用了2.5%碳酸氢钠灌洗肺部的治疗方法，最终取得了良好的治疗效果和预后。此外，本报告还总结了术前对此类患者的准备工作，并结合超声影像学和双腔管的应用，探讨了预防反流误吸的策略。

Abstract: As a rare disease (only about 1 per 100,000 people), esophageal achalasia is mainly characterized by dysfunction of the pancreatic sphincter, resulting in difficulty in the passage of food through the esophagus. Reflux aspiration is one of the common complications in patients with esophageal achalasia and may lead to serious respiratory complications. This report discusses a case of esophageal achalasia in which the patient experienced reflux aspiration during anesthesia. Addressing the characteristics of aspirated reflux material, treatment involved pulmonary lavage with 2.5% sodium bicarbonate, resulting in favorable therapeutic outcomes and prognosis. Furthermore, the report outlines preoperative preparations for such patients and explores strategies for preventing reflux aspiration, integrating the use of ultrasound imaging and double-lumen tubes.