卵巢畸胎瘤致抗N-甲基-D-天冬氨酸受体脑炎患者麻醉管理1例

Anesthesia management in a patient with anti-N-methyl-D-aspartate receptor encephalitis induced by ovarian teratoma

自身免疫性脑炎泛指一大类免疫系统针对中枢神经系统抗原产生反应而导致的炎症性脑病,可导致痫样发作,认知、记忆力障碍,精神行为异常,意识障碍,严重时可危及生命。抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种与抗NMDAR抗体相关的自身免疫性脑炎,通常累及年轻女性,且常伴有卵巢畸胎瘤。由于NMDAR是许多麻醉药物的重要靶点,因此抗NMDAR脑炎患者的围手术期麻醉管理是一个挑战,目前尚无针对这类病人麻醉的标准麻醉方法。本文介绍1例卵巢畸胎瘤致抗N-甲基-D-天冬氨酸受体脑炎患者麻醉管理情况,以期为大家在临床工作中处理此类患者提供一定帮助。

Autoimmune encephalitis generally refers to a large class of inflammatory encephalopathy caused by immune system response to central nervous system antigens,which can lead to seizures,cognitive and memory disorders,mental and behavioral disorders,and disturbance of consciousness.In severe cases,it can be life-threatening.Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis is an autoimmune encephalitis associated with anti-NMDAR antibodies,which usually affects young women and is often associated with ovarian teratoma.Because NMDAR is an important target of many anesthetic drugs,so perioperative anesthetic management of patients with anti-NMDAR encephalitis is a challenge,and there is no standard anesthetic method for such patients.This paper introduces the anesthetic management of a patient with anti-Nmethyl-D-aspartate receptor encephalitis caused by ovarian teratoma,in order to provide some help for everyone to deal with this kind of patients in clinical work.