合并冠心病老年患者椎体转移癌切除术的麻醉与围术期管理  

Anesthesia and perioperative management of an elderly patient with coronary heart disease undergoing metastatic spine tumor surgery

作　　者：冯华[1] 鲁世保[2] 王迎斌[3] 李建军[4] 郭向阳[5] 郭连瑞[6] 薛张纲 王天龙[1] Feng Hua;Lu Shibao;Wang Yingbin;Li Jianjun;Guo Xiangyang;Guo Lianrui;Xue Zhanggang;Wang Tianlong(Department of Anesthesiology,Xuanwu Hospital,Capital Medical College Hospital,Beijing 100053,China;Department of Orthopaedics,Xuanwu Hospital,Capital Medical College Hospital,Beijing 100053,China;Department of Anesthesiology,Lanzhou University Second Hospital,Lanzhou 730030,China;Department of Anesthesiology,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Anesthesiology,Peking University Third Hospital,Beijng 100191,China;Department of Vascular Surgery,Xuanwu Hospital,Capital Medical College Hospital,Beijing 100053,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]首都医科大学宣武医院麻醉手术科,北京100053 [2]首都医科大学宣武医院骨科,北京10053 [3]兰州大学第二医院麻醉科,730030 [4]山东大学齐鲁医院麻醉科,济南250012 [5]北京大学第三医院麻醉科,100191 [6]首都医科大学宣武医院血管外科,北京100053 [7]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中华麻醉学杂志》2021年第12期1421-1424,共4页Chinese Journal of Anesthesiology

摘　　要：(1)一般情况:患者男性,年龄68岁,身高168 cm,体重53 kg。因"双下肢无力伴大小便失禁9月余"入院。患者9月余前出现双下肢无力,行走困难,后逐渐出现二便控制能力下降、双下肢肌力逐渐减至0级。背部疼痛剧烈,不能翻身,睡眠障碍。患者腰椎磁共振检查提示椎体多发转移癌(T7-9,肾透明细胞癌转移),胸椎管狭窄,胸段脊髓受压。拟行椎体肿瘤切除术+胸椎后路减压椎弓根钉内固定融合术+椎管减压术。

关 键 词：大小便失禁 椎管减压术 双下肢肌力 肾透明细胞癌 胸椎管狭窄 胸段脊髓 磁共振检查 围术期管理 

分 类 号：R738.1[医药卫生—肿瘤] R541.4[医药卫生—临床医学]