巴马小型猪肝大部切除术的麻醉管理  

Anesthesia management of the Bama minipigs for major hepatectomy

作　　者：张昌盛[1] 张爱群[2] 许寅喆 王显望[1] 曹江北[1] 董家鸿[2] 米卫东[1] 

机构地区：[1]解放军总医院麻醉手术中心,北京100853 [2]解放军总医院全军肝胆外科研究所,北京100853

出　　处：《中国比较医学杂志》2013年第11期64-67,共4页Chinese Journal of Comparative Medicine

基　　金：国家科技支撑计划项目(2012BAI06B01)

摘　　要：目的探讨巴马猪肝大部切除术的麻醉管理策略。方法健康雄性巴马猪30头，采用肌肉注射氯胺酮12mg／kg镇静后，戊巴比妥钠24mg／kg诱导气管内插管，行肝左三叶切除术，术中异氟醚维持麻醉。术中依据循环波动适时调整麻醉用药，依据脉氧饱和度和呼气末二氧化碳分压调整机械通气参数。结果实验所用30例巴马猪中，26例安全度过围手术期，手术过程中平均动脉压（MAP）变化幅度均〈20％，颈静脉压（JVP）维持在3～6mmH2O，脉氧饱和度（SpO2）均保持在95％以上，3例发生不良事件。结论小型猪肝大部切除术的麻醉要求用药适当、监测完善、液体管理良好、生理指标异常的及时妥善处理，尤其重视在肝大部切除前后维持循环稳定，妥善保护剩余肝脏功能。Objective To explore the management of anesthesia of the Bama minipigs for major hepatectomy. Methods 30 healthy male Bama minipigs were chosen for hepatic trisegmentectomy. Ketamine 12 mg/kg were given by intramuseular for basic anesthesia before anesthesia induction and intubation using pentobarbital sodium 24 mg/kg. Isoflurane inhalation anesthesia was used for anesthesia maintenance. Anesthetics dosages were adjusted according to the change of hemodynamics. And the mechanical ventilation parameters were regulated in accordance with SPO2 and PETCO2. Results 26 of the 30 Bama minipigs get through the perioperative period successfully. The range of the mean arterial pressure （MAP） was less than 20% and the jugular venous pressure （JVP） was kept at 3 - 6mmH2O during the operation. And the SPO2 was kept above 95% throughout the operation. Adverse event was occurred on 3 pigs. Conclusion The management of anesthesia of the Bama minipigs for major hepatectomy needs appropriate drug and fluid management, complete monitoring, and properly handling the abnormity of physical signs. The hemodynamics stability during the hepatectomy and the treatment of the residue liver are of great importance to anesthesia management.

关 键 词：麻醉管理 肝大部切除术 巴马猪 

分 类 号：R614.27[医药卫生—麻醉学] R332[医药卫生—外科学]