颈静脉球体瘤切除术的麻醉管理  

Anesthetic management of patients undergoing glomus jugular tumor resection

作　　者：刘九红[1] 迟晓慧[1] 张光磊[1] 周静[1] 吴震[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030

出　　处：《临床外科杂志》2014年第10期780-782,共3页Journal of Clinical Surgery

基　　金：湖北省自然科学基金资助（项目编号：2013CFB171）

摘　　要：目的：探讨颈静脉球体瘤切除术的麻醉管理特点。方法回顾性分析2006年1月至2014年5月13例颈静脉球体瘤患者行肿瘤切除手术的围术期资料。结果13例患者麻醉过程均平稳。平均手术时间（7．23±3．49）h，最大失血量为1100 ml，最大输注浓缩红细胞量为4 U；1例坐位患者术中出现空气栓塞，通过中心静脉导管抽气后缓解；1例患者术中吸引头误吸面神经，术后出现面神经永久性损伤。结论麻醉前全面仔细地评估患者病情，监测血浆儿茶酚胺含量，选择适当的麻醉方法，合理使用肌肉松弛剂，适当地控制性降压，积极进行颅神经功能监测，及时发现气栓、失血和神经损伤并及时处理，是颈静脉球体瘤手术切除术中麻醉管理的重点。Objective To explore the characteristics of anesthetic management in patients undergoing glomus jugular tumor resection. Methods The clinical data of 13 patients with glomus jugulartumor underwent surgery in our hospital from May 2006 to May 2014 were reviewed retrospectively. Results All operations were accomplished successfully.The average duration of were（7.23 ±3.49）h,thegreatest blood loss was 1100 ml and the greatest blood transfusion was 4 units.Air embolism was found inone sitting patient,and was cleared through a central venous catheter.One patient appeared permanent facial paralysis after an uncareful sunction of the facial nerve.Conclusion Comprehensive preoperative evaluation,serum catecholamine surveillance,proper anesthetic method,reasonable muscle relaxation,appropriate controlled hypotension,active neurophysiological monitoring and timely detection and treatment ofembolism,blood loss and nerve damage are the key points of anesthetic management in patients undergoingglomus jugular tumor resection.

关 键 词：颈静脉球体瘤 颅神经电生理功能监测 七氟烷 瑞芬太尼 控制性降压 

分 类 号：R614[医药卫生—麻醉学]