猪同种原位背驮式肝移植术的麻醉  

Anesthesia of isotype orthotopic piggyback liver transplantation of pig

作　　者：崔剑[1] 陶国才[1] 易斌[1] 鲁开智[1] 毕敏[1] 

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《重庆医学》2002年第10期921-923,共3页Chongqing medicine

摘　　要：目的　观察猪同种原位背驮式肝移植术和麻醉过程中的生命体征及内环境变化 ,探讨猪的原位肝移植术的麻醉处理方法。方法　氯胺酮 +氟哌啶麻醉诱导 ,采用气管插管机械通气 ,氯胺酮 +琥珀胆碱 (或泮库溴铵 )维持麻醉 ,辅以小剂量多巴胺等血管活性药物支持循环、维持血流动力学稳定 ,施行同种异体原位背驮式肝移植术。结果　在肝移植麻醉及手术过程中 ,中心静脉压 (CVP)、血压 (BP)、心率 (HR)、碱剩余 (BE)、动脉血二氧化碳分压 (PaCO2 )等均有较大的波动 ,其中在无肝期至新肝期后0 .5h是变化最剧烈的时段 (P <0 .0 5 ) ,由于实行机械通气 ,动脉血氧分压 (PaO2 )在各时段无显著差别 (P >0 .1)。结论　运用氯胺酮 +肌松剂为主的麻醉、配合适当的血管活性药物及呼吸支持 ,能很好地满足猪的同种原位肝移植的实验手术 ,合理应对无肝期至新肝期后 0 .5h之间的循环系统和机体内环境的剧烈变化是麻醉是否成功的关键。但是尚有很多关于猪的麻醉手术时的生理参数值得探讨。Objective To study the change of the life sign and internal environment in the procedure of orthotopic piggyback liver transplantation and anesthesia of pigs. Try to access the anesthesia measurements and emergence treatments in orthotopic piggyback liver transplantation of pigs. Methods Ketamine and Drpoeridol, and then tracheal induction and mechanical ventilation inducted the pig. Anesthesia maintained with Ketamine, Scoline (or Pancuronium), and used the reasonable cardiovascular drugs (such as Dopamine) to keep hemodynamics stable in the operation. Results In the process of anesthesia and operation, center vein pressure, blood pressure, heart rate, base excess and partial pressure of carbon dioxide in artery were all fluctuation intensely, especially in the period between anhepatic phase and half an hour after the planting of the new liver ( P <0.05). The partial pressure of oxygen had no significant difference due to mechanical ventilation ( P >0.1). Conclusion The measurements we anesthetized the pig with Ketamine and neuromuscular blocking drugs (such as Scoline or Pancuronium) cooperated with some reasonable cardiovascular drugs and mechanical ventilation in the experiment suit the isotype orthotopic piggyback liver transplantation of pigs. The measurements we adopted in the period between anhepatic phase and half an hour after the planting of the new liver determine the success of the anesthesia. But some of the physiological parameters of pig in the condition of anesthesia and operation need to be studied in the future.

关 键 词：同种原位移植 动物实验 背驮式肝移植术 麻醉 

分 类 号：R614[医药卫生—麻醉学]