猪腹主动脉瘤模型建立及腔内修复术中的麻醉管理研究  

Anesthesia management for swine model for abdominal aortic aneurysm and endovascular aneurysm repairment

作　　者：姜雪莺[1] 吴巍巍[2] 李天佐[1] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,100730 [2]中国医学科学院北京协和医科大学北京协和医院血管外科

出　　处：《北京医学》2013年第8期635-638,共4页Beijing Medical Journal

摘　　要：目的观察猪腹主动脉瘤模型建立及腔内修复术麻醉过程中的生命体征变化,探讨该类手术猪的围术期麻醉管理。方法 10例猪在全麻下建立腹主动脉瘤模型并实施腔内修复术,麻醉采用气管内插管静脉复合麻醉技术,持续监测心电图、脉搏血氧饱和度、动脉血压。在进行手术关键步骤时实施控制性降压。结果气管插管一次成功率为90%,术中麻醉效果满意。主动脉阻断即刻心率增快[(82.7±9.9)vs.(96.8±9.2)次/min;P<0.001];主动脉阻断后收缩压显著增高[(131.9±10.9)vs.(120.5±10.2)mmHg,P=0.006],开放阻断后收缩压显著下降[(109.1±13.7)vs.(130.1±10.8)mmHg,P=0.003],释放支架后收缩压[(94.6±3.0)vs.(120.0±8.9)mmHg,P<0.001]和舒张压[(61.3±2.3)vs.(66.9±4.9)mmHg,P=0.004]均显著下降。结论采用气管内插管机械通气的全身麻醉用于猪开腹腹主动脉瘤模型建立及腔内修复术效果满意,关键步骤实施控制性降压是该手术围术期麻醉管理的重点。Objective To observe the vital signs during anesthesia in establishing swine models for abdominal aor-tic aneurysm and endovascular aneurysm repairment, and to share the experiences on anesthesia management during such procedures. Methods Ten swine were generally anesthetized for constructing aneurysm and repairment model and. Intra-venous general anesthesia with endotracheal intubation was applied. Electrocardiogram, pulse oximetry and arterial pressure were continuously monitored. Controlled hypotension approach was applied during the key steps of the procedures. Results The percentage of successful intubation at the first attempt was 90%, anesthesia was very smooth with acceptable hemody-namic fluctuation. The heart rate rose significantly after the aortic clamping [（82.7±9.9） vs. （96.8±9.2）bpm, P 〈 0.001]. The systolic pressure elevated significantly after the aortic was clamped [（131.9±10.9） vs. （120.5±10.2）mmHg, P = 0.006], while it decreased significantly after the clamp was removed [（ 109.1 ±13.7） vs. （130.1 ±10.8）mmHg, P = 0.003]. The sys-tolic pressure was controlled to （94.6±3.0）mmHg before the deployment of the stent graft. Conclusion General anesthesia with endotracheat intubation is effectively and can be safely applied when constructing abdominal aortic aneurysm and en- dovascular aneurysm repairmen swine models. Controlled hypotension in the key steps during the procedure is critical to anesthesia management during the operation.

关 键 词：腹主动脉瘤 麻醉 模型 猪 

分 类 号：R614[医药卫生—麻醉学]