脑垂体腺瘤围术期麻醉管理进展  

Progress in perioperative anesthesia management of pituitary adenoma

作　　者：付宇翾 于芸[1] 韩如泉[1] FU Yuxuan;YU Yun;HAN Ruquan(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,100070

出　　处：《临床麻醉学杂志》2021年第11期1225-1228,共4页Journal of Clinical Anesthesiology

摘　　要：脑垂体腺瘤是起源于垂体的良性肿瘤。脑垂体腺瘤手术的麻醉管理始于全面的术前评估,重点关注肿瘤解剖与病理生理特征、激素水平变化、气道、呼吸与心功能变化。由于激素水平紊乱,垂体腺瘤患者是围术期潜在困难气道人群。鼻内镜下经蝶窦垂体腺瘤切除术中疼痛刺激大,需要足够的镇静深度及镇痛强度以维持血流动力学稳定。术中麻醉方式的选择以循环稳定为基础,同时达到缩短苏醒时间、提高康复质量的目的。麻醉苏醒期关注通气情况,避免低通气和呼吸道梗阻,及时识别缺氧高危患者,避免术后气颅发生。麻醉科医师应根据垂体腺瘤病理类型及激素表达情况,制定针对性的围术期管理方案。A pituitary adenoma is a benign tumor originating from the pituitary gland.The anesthetic management of pituitary adenoma begins with a comprehensive preoperative assessment,focusing on tumor anatomical and pathophysiological features,hormonal changes,airway,respiratory,and cardiac function transformation.Patients with pituitary adenoma are potentially difficult airway patients due to disordered hormone levels.The pain is stimulated during endoscopic sphenoid sinus pituitary adenectomy.Thus,sufficient sedative depth and analgesic intensity are required to maintain hemodynamic stability.The selection of anesthesia mode is based on hemodynamic stability and achieves the purpose of shortening the time of recovery and improving the quality of rehabilitation.Attention should be paid to ventilation during anesthesia recovery to avoid hypoventilation and respiratory obstruction,a well as timely identifying high-risk patients with hypoxia to avoid postoperative craniotomy.It is used to develop specific perioperative management programs according to the pathological type of pituitary adenoma and hormone expression.

关 键 词：脑垂体腺瘤 围术期 麻醉管理 

分 类 号：R736.4[医药卫生—肿瘤] R614[医药卫生—临床医学]