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各类激光手术仪器已日益频繁地被用于临床手术,除已知的各种对眼、皮肤及其他正常组织的损害危险外,尚有未受重视的潜在致命危险—气栓,均须于术中采取安全措施。本文报告1例40天足月平产男婴,出生后15天表现呼吸困难、发绀、鼻溢,诊为先天性双后孔闭锁,在全麻监护、仰卧肩高位下,用以2L/分钟流量的氮行同轴冷却的Nd-YAG激光兰宝石头端插入鼻腔手术,由于手术不顺利,损伤较大,多次操作,术中心跳突减慢至40次/分,持续发绀,出现左面气肿,虽经多方抢救仍死亡,胸片有纵隔气肿,尸检有左胸腔积液、纵隔气肿、心室扩大、卵圆孔未闭,结论为死于氮气气栓。
Various types of laser surgical instruments have been used more and more frequently in clinical operations. In addition to the various known risks of damage to the eyes, skin and other normal tissues, there are potentially fatal dangers unappreciated - air plugs, Surgery to take safety measures. This article reports a case of 40-day full-term baby boy, 15 days after birth showed dyspnea, cyanosis, rhinorrhea, diagnosed with congenital double posterior orifice block, under general anesthesia monitoring, supine shoulder high, with 2L / min Flow of nitrogen line co-axial cooling Nd-YAG laser sapphire head end nasal surgery, due to the operation is not smooth, more damage, multiple operations, intraoperative sudden slowing to 40 beats / min, continuous cyanosis, there left Although emphysema was still rescued by multiple rescues, there was mediastinal emphysema in the chest radiograph, left pleural effusion in the autopsy, emphysema in the mediastinum, enlargement of the ventricle, and patent foramen ovale. The conclusion was that the patient died of nitrogen gas embolism.