肾移植术的全身麻醉处理  

The general anesthesia of renal transplantation

作　　者：鲁开智[1] 邓安智[1] 易斌[1] 赵宝生[1] 曹剑[1] 王秀琼[1] 张铭[1] 顾健腾[1] 陶国才[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936-937,共2页Chongqing medicine

摘　　要：目的　总结我院 12 0例肾移植术全身麻醉经验 ,旨在探讨肾移植术全身麻醉处理的特殊性。方法　受者男 79例 ,女4 1例 ,原发病种类为慢性肾小球肾炎 118例 (98% ) ,多囊肾 2例。麻醉诱导 :静脉给予芬太尼、氟哌啶、异丙酚、维库溴铵、佩尔地平气管内插管或置入喉罩 ,接呼吸机行机械通气。麻醉维持以N2 O、异丙酚、芬太尼、维库溴铵。以予硝酸甘油 ,间断静注佩尔地平控制血压增高。术中补液以胶体血定安或贺斯和全血为主 ,移植肾在血管吻合开放前加快补液、血速度 ,给予多巴胺和纠正酸碱失衡。结果　手术时间 1.8～ 6 .5h。全部病人术毕 30min内均清醒拔出气管导管或喉罩 ,无麻醉死亡及并发症发生。结论　充分的术前准备 ,合理的麻醉药物选择 ,以及围术期的循环。Objective To summarize the experiences about 120 cases undergone renal transplantation. Methods Recipient included 79 men and 41 women. 112 patients suffered chronic glomerulonephritis and 2 polycystic kidney. Anesthesia induction: fentannvl,droperidol,propofol,vecuronium and perdipine were injected in vein and endotracheal intubation or laryngeal mask. Use breathing apparatus for mechanical ventilation. Nitrous oxygen,propofol,fentanvl and vecuronium were used to maintenance of anesthesia. Nitroglycerin and perdipine were used to control high blood pressure. Colloid and blood were used for fluid replacement. Step up the speed of transfusion,offering dopamine and redressing acid base disequilibrium before the opening vascular anastomosis. Results The operative time was 1.8～6.5h. All patients were wakefulness and endotracheal extubation in 30min, there was no anesthetic death and complications. Conclusion Sufficient preoperation,reasonable usage of anesthetic and maintenance of perioperative circulation,breathe, water electrolyte and acid base balance were the key for successful general anesthesia of renal transplantion.

关 键 词：肾移植术 全身麻醉 临床分析 终末期肾病 

分 类 号：R614[医药卫生—麻醉学]