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女性病人,36岁,右桥小脑角脑膜瘤,拟在坐位下行右枕下乙状窦后入路桥小脑角脑膜瘤切除术.术前患者无系统合并症,意识及定向力正常.麻醉诱导后放置经食道超声心动图(TEE)监测探头,行术中TEE监测;在TEE引导下将中心静脉导管放置至右心房顶端,以备清除术中气栓.手术开始前未见右心房气栓及心房水平的左向右分流;术中肿瘤切除过程中发现右心房气栓,并反常性经卵圆孔进入左心房,经中心静脉导管可有效清除由上腔静脉进入的右心房气栓.术后病人恢复良好出院.坐位手术中常合并空气栓塞,气栓可反常性经卵圆孔进入左心房,TEE可指导中心静脉导管定位,并可及时发现气栓并有效治疗.TEE应成为坐位手术的必备监测手段.
Female patient, 36 years old, right cerebellopontine meningioma, is intended to sit in the right posterior submandibular sigmoid sinus approach into the cerebellopontine angle meningioma surgery .No preoperative system complications, consciousness and orientation normal .Anesthesia after induction Placed transesophageal echocardiography (TEE) monitoring probe, intraoperative TEE monitoring; under the guidance of the TEE will be placed in the central venous catheter to the top of the right atrium to prepare for the removal of intraoperative air embolism .At the beginning of surgery no right atrial thrombus and Atrial level left to right shunt; intraoperative resection of the tumor found in the right atrium air plugs, and abnormalities through the foramen ovale into the left atrium, the central venous catheter can be effectively removed by the superior vena cava into the right atrial thrombus. After the patient recovered well discharged.Surgery surgery often associated with air embolism, anomalies can be anomalous air foramen into the left atrium, TEE can guide the central venous catheter positioning, and timely detection of air embolus and effective treatment .TEE should be sitting operation Necessary means of monitoring.