游意莹?王艳玲?谢汉镔

    【摘要】强直性脊柱炎(AS)是一种以中轴关节受累为主的慢性炎症性疾病，严重者发生脊柱强直和畸形，属于困难气道的高危情况。该类患者术前应充分评估和准备，选择最佳麻醉方案，减少并发症发生。该文报道1例47岁男性腰椎、胸椎、颈椎强直，双髋关节、双膝关节强直呈“S”型固定体位的重度AS患者，因椎管内肿物拟于全身麻醉下接受手术治疗，使用右美托咪定清醒镇静在纤维支气管镜引导下气管插管的成功案例。该例提示右美托咪定清醒镇静不仅对呼吸功能影响轻微，而且能够提高患者接受操作期间的舒适度和配合度，为纤维支气管镜引导下气管插管提供满意的条件。

    【关键词】强直性脊柱炎;纤维支气管镜;清醒气管插管;右美托咪定

    Awake tracheal intubation guided by fiberoptic bronchoscope in a patient with ankylosing spondylitis： one case report You yiying， Wang Yanling，Xie Hanbin. Department of Anesthesiology， the Third Affiliated Hospital of Sun Yat-sen University， Guangzhou 510630， China

    Corresponding author， Wang Yanling

    【Abstract】Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly involving the axial joints. Spinal ankylosis and deformity can occur in severe cases， which belong to high risk of difficult airway. Comprehensive preoperative evaluation and preparation and optimal anesthetic plan should be performed to decrease the incidence of complications for these patients. We reported a case of severe AS (47-year-old male) manifested with lumbar ......