小儿主动脉缩窄矫正手术的麻醉处理  

The anesthetic management of remedy operation for coarctation of aorta in infants and children

作　　者：彭明清[1] 叶茂[1] 王洪[1] 柏林[1] 

机构地区：[1]重庆医科大学儿童医院麻醉科,重庆400014

出　　处：《重庆医科大学学报》2007年第11期1210-1211,1217,共3页Journal of Chongqing Medical University

摘　　要：目的:探讨小儿主动脉缩窄矫正手术的麻醉处理特点。方法:回顾性分析我院2000年1月～2006年12月手术治疗32例主动脉缩窄矫正手术的麻醉资料。结果:全部病例在全麻气管插管、控制性降压、低温下行主动脉缩窄矫正术,麻醉诱导及阻断主动脉时上肢收缩压(SBP)维持在90～120mmHg,下肢血压40～60mmHg,上下肢血压差异显著(P<0.05)。阻断主动脉时间35～55min,阻断期间用硝普钠或硝酸甘油降压,上肢血压维持60～80mmHg,温度32～33℃。开放主动脉后上肢血压维持80～105mmHg,下肢较上肢低10～15mmHg,无显著差异(P>0.05)。术后出现高血压3例,低血压12例,无急性心衰、心律失常和肾功能衰竭发生。结论:小儿主动脉缩窄矫正手术麻醉的关键在于麻醉方式的选择、术中适当的控制性降压、降温和并发症的预防。Objective：To discuss the anesthetic management of remedy operation for coarctation of aorta in infants and children. Methods：The anesthetic data of thirty-two patients undergoing remedy operation for coarctation of aorta in infants and children from Jan,2000 to Nov,2006 were reviewed retrospectively. Results：All cases underwent remedy operation for coarctation of aorta under general anaesthesia,controlled hypotension with nitroprusside sodium or glycerol trinitrate,and at low temperature, with the different blood pressure of upper limbs and lower limbs maintained during the operation. When anaesthesia was induction and the aorta blocked,the difference in blood pressure of upper limbs and lower limbs is statistically remarkable （P〈0.05）,and after the aorta opened,the blood pressure of upper limbs and lower limbs is no obvious difference （P〉0.05）. The complication such as acute heart failure,arrhythmia and kidney function failure did not happen except in 3 cases with high blood pressure and 12 cases with hypotension. Conclusions：The key of anesthetic treatment for coarctation of aorta in infants and children should be anesthetic selection,controlled hypotension,low temperature during operation and prevention of complications

关 键 词：麻醉 主动脉缩窄 控制性降压 低温 小儿 

分 类 号：R614.2[医药卫生—麻醉学]