头颈部副节瘤围术期麻醉管理分析  

The anesthesia for paragangliomas surgery of head and neck

作　　者：王敏[1] 刘毅[1] 米卫东[1] 

机构地区：[1]解放军总医院麻醉手术中心,北京100853

出　　处：《北京医学》2012年第8期693-695,共3页Beijing Medical Journal

摘　　要：目的探讨头颈部副神经节瘤(简称副节瘤)的麻醉管理。方法回顾性分析我院2002年1月至2011年12月经术后病理诊断为头颈部副节瘤的101例患者的围术期麻醉管理。结果 1例患者因呼吸道狭窄、气管插管不成功,行气管切开。10例患者在肿瘤探查及切除时血压升高,收缩压平均(174.7±17.5)mmHg,给予乌拉地尔、佩尔地平、酚妥拉明、硝普钠等对症处理后稳定;肿瘤切除后血压明显降低者5例,给予去氧肾上腺素、多巴胺升高血压。9例患者术中阻断颈总动脉11～15min,期间给予多巴胺、去氧肾上腺素等维持收缩压>140mmHg以提高脑灌注。1例行右侧颈动脉体瘤切除、颈内动脉修补术的9岁患儿,术后当天左侧肢体偏瘫,左侧面瘫及右侧霍纳征,给予脱水、神经营养及康复训练。所有患者均安全完成手术麻醉。结论保证循环的稳定性、维持正常脑灌注、避免脑缺血,是头颈部副节瘤手术麻醉的关键。Objective To explore the anesthesia of head and neck paragangliomas surgery. Methods 101 cases diagnosed as head and neck paragangliomas by postoperative histopathology between Jan 2002 and Dee 2011 were re- viewed. Results Tracheotomy was taken after intubation failure in one patient with abnormal airway. Three patients suf- fered from hypertension when the tumor was manipulated. All patients finished the operations safely. Conclusion Main- taining cerebral blood flow and avoiding cerebral isehemia are the key points of head and neck paragangliomas anesthesia.

关 键 词：头颈部 副神经节瘤 麻醉 

分 类 号：R739.91[医药卫生—肿瘤]