肺动脉血栓内膜剥脱术的麻醉和脏器保护方法——阜外经验  

Anesthesia and Organ Protection of Pulmonary Endarterectomy——A Single-Center Experience in Fuwai Hospital

作　　者：张丛雅 周荟[1] 王古岩[1] 伍丽明 韩志岩 杜娟[2] 刘盛[2] 

机构地区：[1]北京协和医学院国家心血管病中心中国医学科学院阜外医院麻醉科,北京市100037 [2]北京协和医学院国家心血管病中心中国医学科学院阜外医院心脏外科,北京市100037

出　　处：《中国分子心脏病学杂志》2017年第6期2280-2283,共4页Molecular Cardiology of China

基　　金：中国医学科学院医学与健康科技创新工程2017-CXGC06

摘　　要：目的回顾性总结慢性血栓栓塞性肺动脉高压患者行肺动脉血栓内膜剥脱术的麻醉和脏器保护方法。方法纳入2016年1月1日至2016年12月31日我院行肺动脉血栓内膜剥脱术的全部患者,记录术前、术中、术后的全部临床资料,对麻醉和脏器保护方法进行分析总结。结果共纳入27例患者,26例在全身麻醉深低温停循环下完成手术,1例在全身麻醉持续低流量下完成。术中漂浮导管测平均肺动脉压由术前(35±14.8)mmHg降低到手术结束时刻的(28±11.6)mmHg,术后肺部感染11例,肺动脉高压危象2例,神经系统并发症躁狂1例,躁狂+谵妄1例,围术期无再灌注肺水肿和死亡病例。结论麻醉管理过程中,应重点关注血流动力学管理,和肺、脑、血液等脏器的保护。Objective The objective was to retrospectively analyze the anesthesia and organ protection strategy during pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension. Methods We reviewed all patients undergoing pulmonary endarterectomy in our hospital from January 1, 2016 to December 31, 2016. All clinical data were recorded in preoperative, intraoperative and postoperative period to analyze the method of anesthesia and organ protection. Results A total of 27 patients were enrolled. The mean pulmonary arterial pressure reduced from preoperative（35 ± 14.8） mmHg to（28 ± 11.6） mmHg at the end of the operation. There was 0 case of pulmonary edema, 11 cases of pulmonary infections, 2 cases of pulmonary hypertensions, 2 cases of neurological complications, and no mortality after operation. Conclusions Anesthesia management process should focus on hemodynamic management, lung, brain, blood and other organs protection.

关 键 词：高血压 肺性 动脉内膜切除术 麻醉 脏器保护 

分 类 号：R614[医药卫生—麻醉学]