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中华妇幼临床医学杂志(电子版) ›› 2017, Vol. 13 ›› Issue (03) : 270 -275. doi: 10.3877/cma.j.issn.1673-5250.2017.03.005

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抗N-甲基-D-天冬氨酸受体脑炎患者卵巢肿瘤切除术的麻醉管理
高兴蓉1, 罗东1,()   
  1. 1. 610041 成都,四川大学华西第二医院麻醉科、出生缺陷与相关妇儿疾病教育部重点实验室
  • 收稿日期:2017-03-01 修回日期:2017-05-11 出版日期:2017-06-01
  • 通信作者: 罗东

Anesthesia management of patients undergoing ovarian tumor excision with anti N-methyl-D-aspartate receptor encephalitis

Xingrong Gao1, Dong Luo1,()   

  1. 1. Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Chengdu 610041, Sichuan Province, China
  • Received:2017-03-01 Revised:2017-05-11 Published:2017-06-01
  • Corresponding author: Dong Luo
  • About author:
    Corresponding author: Luo Dong, Email:
引用本文:

高兴蓉, 罗东. 抗N-甲基-D-天冬氨酸受体脑炎患者卵巢肿瘤切除术的麻醉管理[J]. 中华妇幼临床医学杂志(电子版), 2017, 13(03): 270-275.

Xingrong Gao, Dong Luo. Anesthesia management of patients undergoing ovarian tumor excision with anti N-methyl-D-aspartate receptor encephalitis[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(03): 270-275.

抗N-甲基-D-天冬氨酸(NMDA)受体脑炎是一种自身免疫性脑炎,临床症状包括精神障碍、癫痫发作、自主神经功能障碍,以及中枢性通气不足等,对该病患者需要进行呼吸支持治疗。直接作用于NMDA受体NR1亚单位的免疫球蛋白(Ig)G抗体的产生,与该病的发生密切相关。该病与卵巢畸胎瘤存在高度相关性,多发生于年轻女性。对合并卵巢畸胎瘤的抗NMDA受体脑炎患者进行卵巢肿瘤切除术联合免疫治疗后,多数患者可完全恢复。对于此类患者进行卵巢肿瘤切除术的理想麻醉方法,临床迄今尚未达成共识。笔者拟就抗NMDA受体脑炎卵巢肿瘤切除术的麻醉管理进行阐述,为此类患者手术治疗的麻醉管理提供参考依据。

Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune encephalitis. Its clinical symptoms include psychiatric disorders, seizure disorders, autonomic instability, central hypoventilation and so on. Anti NMDA receptor encephalitis patients need respiratory support. This disease is directly associated with the immunoglobulin (Ig) G antibodies against NMDA receptor NR1 subunit. Anti NMDA receptor encephalitis is commonly associated with ovarian teratomas and typically occurs in young women. The removal of ovarian teratomas combined with immunotherapy, is always associated with a good prognosis. It is still not consistent on the ideal anesthesia method for this kind of patients undergoing ovarian tumor excision. We review the anesthesia management of patients with anti NMDA receptor encephalitis undergoing ovarian teratoma excision in order to provide references for such patients.

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