功能性单心室患者行非心脏手术的麻醉管理进展  

Anesthetic management progress of patients with functional single ventricle undergoing non-cardiac surgery

作　　者：孔昊[1] 马丹丹 张思宇 李雪[1] KONG Hao;MA Dandan;ZHANG Siyu;LI Xue(Department of Anesthesiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院麻醉科,100034 [2]山东省潍坊市益都中心医院麻醉科 [3]中国医学科学院阜外医院心外科

出　　处：《临床麻醉学杂志》2022年第2期207-212,共6页Journal of Clinical Anesthesiology

摘　　要：功能性单心室是指在心脏功能上由发育良好的单一心室独立供应体循环和肺循环,这种特殊的循环系统对行非心脏手术时的麻醉管理提出了巨大挑战,患者常伴随术后严重不良事件。单心室患者行非心脏手术时麻醉管理的重点是维持适当的肺循环和体循环血流比例和正常的心肌收缩力,保证足够的血液氧合和体循环的氧耗需求。全文介绍单心室患者3次心脏分期手术的手术方式和手术前后的4种循环系统特点,重点探讨在四种不同循环系统下麻醉管理的注意事项和解决方法。Functional single ventricle refers to the independent supply of systemic circulation and pulmonary circulation only by one well-developed ventricle.This unique circulatory system poses a great challenge to anesthetic management in non-cardiac surgery.Patients with functional single ventricle often complicated serious adverse events after surgery.The key points of anesthetic management for patients with single ventricle undergoing non-cardiac surgery are to maintain a rational pulmonary to systemic blood flow ratio and normal myocardial contractility to ensure adequate blood oxygenation and systemic oxygen consumption.This review narrates the surgical methods of 3-staged cardiac procedures and the characteristics of 4 different circulatory systems,focuses on the anesthetic considerations and treatment strategies in patients with each circulatory system.

关 键 词：功能性单心室 非心脏手术 麻醉管理 

分 类 号：R614[医药卫生—麻醉学]