1例贲门失迟缓症患者麻醉中反流误吸及管理

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。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.

罗哌卡因的抗肿瘤作用机制及控释体系应用

恶性肿瘤病死率逐年增高,对人类的生活造成了难以预计的影响。目前针对恶性肿瘤仍以手术切除为主,辅助以放疗、化疗等,但仍存在肿瘤复发及转移等问题。围术期手术操作及麻醉可通过多种因素对肿瘤的预后造成影响,包括改变肿瘤局部微环境变化、提升炎症及应激水平、抑制免疫等促进恶性肿瘤进展,增加术后肿瘤复发及转移风险。近年来研究发现,罗哌卡因(Ropivacaine, RVC)能够通过多种途径影响肿瘤进展,抑制肿瘤活性及转移。文中就罗哌卡因对肿瘤的影响及药物递送体系的应用予以综述,旨在探讨围手术期罗哌卡因及其控释体系在肿瘤中的作用。