监测麻醉在经股动脉主动脉瓣植入术中的应用  

Application of monitored anesthesia care in the transfemoral aortic valve implantation

作　　者：林多茂[1] 张冬妮 卢家凯[1] 马骏[1] LIN Duomao;ZHANG Dongni;LU Jiakai;MA Jun(Department of Center of Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉中心,100029

出　　处：《心肺血管病杂志》2021年第3期258-260,277,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市医院管理中心“青苗”计划(QML20180602)。

摘　　要：目的:探讨监测麻醉在经股动脉主动脉瓣植入术中的安全、可行性及麻醉管理要点。方法:选择2017年3月到2020年2月,在北京安贞医院行经股动脉主动脉瓣植入术的患者54例,麻醉方式采用股动脉局部麻醉,辅以监测麻醉(MAC),动静脉穿刺置管测压,多参数监测,放置鼻咽导管维持气道通畅,适当的镇静镇痛,必要时给与血管活性药物维持循环,记录不同时段的血流动力学参数,记录围术期并发症以及死亡情况。结果:所有患者均成功置入主动脉瓣,对MAC耐受良好,无麻醉相关并发症。术中心脏破裂大出血死亡1例。结论:MAC可以安全有效的应用于经股动脉主动脉瓣植入术中。Objective: To explore the safety, feasibility and key points of monitored anesthesia care in the operation of transfemoral aortic valve implantation. Methods: From March 2017 to February 2020, 54 patients who underwent the transfemoral aortic valve implantation in Beijing Anzhen Hospital were selected. The method of anesthesia was local anesthesia of femoral artery with monitored anesthesia care, pressure measurement by arteriovenous catheterization, multi parameter monitoring, placement of nasopharynx catheter to maintain airway patency, appropriate sedation and analgesia, and vasoactive drugs to maintain circulation if necessary, Hemodynamic parameters were recorded in different periods, and perioperative complications and deaths were recorded. Results: The aortic valve was successfully implanted in all patients, and the monitored anesthesia care was well tolerated without anesthesia related complications. One case died of bleeding. Conclusions: Monitored anesthesia care can be used safely and effectively in the transfemoral aortic valve implantation.

关 键 词：经股动脉主动脉瓣植入术 监测麻醉 

分 类 号：R54[医药卫生—心血管疾病]