Vô cảm cho phẫu thuật cắt hoại tử bỏng ghép da ở bệnh nhân bạch cầu cấp (Thông báo lâm sàng)

Abstract

Introduction: The National Burn Hospital doesn’t often necrosis excision for acute leukemia. Therefore, the choice of anesthesia method for necrosis excision in these patients needs to be carefully considered because they often suffer from immunosuppression, anemia, and thrombocytopenia. On January 8^th, 2018 we made general anesthesia for necrosis excision in an acute leukemia patient.
Case Presentation: 9-year-old male Vu Hong Q., the patient had a history of acute leukemia detected and treated several times at the National Hospital of Hematology and Transfusion.
One month before admission to the National Burn Hospital, he appeared an ulcer on his left leg that did not heal and admitted to the intensive care unit of the National Burns Hospital on January 4^th, 2018 in a state of consciousness, body temperature 37⁰5C, pulse rate 103 bpm, blood pressure 115/65mmHg, pale mucous, SpO₂ 98% on room air, clear breath sound on bilateral lung fields, no rale, slight abdominal distention. There was 7% total body surface area of bad odor purple necrosis of level IV and V on left leg.
He was diagnosed when admission to the intensive care unit with was 7% total body surface area of necrosis of left leg in patients with acute leukemia L2. Tests before surgery showed anemia, thrombocytopenia. At 10:45 on January 8^th, 2018, he was transferred to the operating room with a preoperative diagnosis of 7% total body surface area of necrosis on the left leg. The surgical method was the necrosis excision of 7% total body surface area on the left leg and skin homograft and the anesthetic method was general anesthesia using a combination of intravenous and inhalational anesthetics with a non-invasive mask. The course of general anesthesia and surgery were safe.
Conclusion: Necrosis excision in an acute leukemia patient could be made efficacious and safe by general anesthesia with a non-invasive mask using a combination of intravenous and inhalational anesthetics.