2例小儿右心房瘤栓取出术的麻醉管理及文献复习  

Anesthetic management of children with right atrial tumor thrombectomy:a report of 2 cases and literature review

作　　者：余倩[1] 叶茂[1] 刘巍[1] 李义辉[1] YU Qian;YE Mao;LIU Wei;LI Yihui(Department of Anesthesiology,Chongqing Children's Hospital/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院麻醉科/儿科学重庆市重点实验室

出　　处：《重庆医学》2019年第11期1912-1915,共4页Chongqing medicine

基　　金：国家临床重点专科建设项目(国卫办医函[2013]544)

摘　　要：目的探讨小儿肾脏肿瘤切除联合右心房瘤栓取出术的麻醉管理策略。方法回顾性分析重庆医科大学附属儿童医院2015-2017年收治的2例肾脏肿瘤伴右心房及下腔静脉瘤栓患儿的临床资料。分析术中血流动力学、动脉血气分析、体外循环及术后转归情况。结果2例患者均顺利完成肾脏肿瘤切除术及深低温停循环下右心房瘤栓取出术,体外循环时间分别是151min和60min,主动脉阻断时间为68min和45min,停循环时间为56min和31min,2例患儿术后均未发生严重并发症,随访10-19个月均无远处转移。结论深低温停循环下实施小儿右心房瘤栓取出术安全可行,术后无严重并发症。Objective To investigate the anesthesia management strategy of pediatric renal tumor resection combined with right atrial tumor thrombectomy. Methods The clinical data of 2 children with renal tumors combined with right atrial and inferior vena cava tumor thrombus admitted to this hospital from^2015 to 2017 were retrospectively analyzed.Intraoperative hemodynamics,arterial blood gas,extracorporeal circulation and postoperative outcomes were analyzed. Results Two patients underwent renal tumor resection and right atrial tumor thrombectomy under deep hypothermia and circulation arrest condition.The extracorporeal circulation time was 151 min and 60 min,aortic occlusion time was 68 min and 45 min,circulation arrest time was 56 min and 31 min,respectively.There was no serious complications occurred in 2 patients after operation and no distant metastasis during 10-19 months follow-up. Conclusion The implementation of pediatric right atrial tumor thrombectomy under deep hypothermia and circulation arrest conditions is safe and feasible,and there are no serious complications after operation.

关 键 词：深低温停循环 右心房瘤栓 小儿麻醉 

分 类 号：R614.25[医药卫生—麻醉学]