强直性脊柱炎伴大面积脑梗死患者行前列腺电切术麻醉管理1例并文献复习

Anesthetic management of a patient with ankylosing spondylitis and massive cerebral infarction undergoing transurethral resection of prostate and literatures review

强直性脊柱炎(AS)伴严重心脑血管疾病的患者围手术期出现紧急气道、心脑血管意外风险高,麻醉管理难度大,但临床上对其普遍认识不足,且未见相关病例报道。本文报道AS合并大面积脑梗死患者1例,入院诊断:前列腺增生;强直性脊柱炎;脑梗死后遗症期。拟在全身麻醉下行经尿道前列腺气化电切术。通过完善的术前准备、困难气道的个体化处理及围手术期脑卒中的预防,患者最终平稳度过围手术期而顺利出院,随访30 d内无新发神经功能障碍。本文通过对该病例回顾性分析并文献复习,为临床提供参考。

Patients with ankylosing spondylitis(AS)with severe cardiovascular and cerebrovascular diseases have a high risk of emergency airway,cardiovascular and cerebrovascular accidents during perioperative period,anesthesia management is difficult,but it is not well understood in clinical practice,and no related cases have been reported.This paper reports a case of AS complicated with massive cerebral infarction.The admitting diagnosis includes:Prostatic hyperplasia;Ankylosing spondylitis;Sequelae of cerebral infarction.Transurethral electrified resection of the prostate was performed under general anesthesia.Through perfect preoperative preparation,individual management of difficult airway and perioperative stroke prevention.The patient finally passed the perioperative period smoothly and was discharged successfully,and no new neurological dysfunction was found within 30 days of follow-up.Through the retrospective analysis of the case and literature review,this paper provides clinical reference.