高龄患者全麻下行经导管主动脉瓣置换术麻醉管理1例  

Anesthesia management in the elderly of transcatheter aortic valve replacement under general anesthesia

作　　者：刘海霞[1] 王天龙[1] 赵磊[1] Liu Haixia;Wang Tianlong;Zhao Lei(Department of Anesthesiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《国际麻醉学与复苏杂志》2023年第3期299-304,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：该患者术前合并高血压、贫血、下肢多支动脉闭塞、慢性支气管炎,入室后还发现低钾血症,且由于其特殊的手术操作对患者循环影响巨大,需要麻醉医师进行良好的术中调控与风险干预,以及与外科有效、及时的沟通协作,以保证围手术期安全。在术中通过尽可能维持血流动力学平稳,保证重要器官灌注,采取抗炎、抗应激、纠正电解质平衡紊乱、抗心律失常、保温等综合处理,该患者成功实施经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR),经ICU及普通病房治疗,顺利出院。This patient had hypertension,anemia,multiple artery occlusion of lower limbs before surgery,and hypokalemia was found after entering the operation room.Due to the particular surgical operation,the patient's circulation was greatly affected dur⁃ing the process.Therefore,the anesthesiologist's good intraoperative regulation and risk intervention,effective and timely communica⁃tion,and cooperation with the surgeon were required to ensure perioperative safety.During the operation,the patient was successfully cured and discharged from the hospital by maintaining hemodynamic stability as much as possible,guaranteeing perfusion of essential organs,taking comprehensive treatment such as anti⁃inflammatory and anti⁃stress,correcting electrolyte balance disorder,anti⁃arrhythmia,and heat preservation.

关 键 词：主动脉瓣狭窄 经导管主动脉瓣置换术 低钾血症 老年人 麻醉管理 

分 类 号：R614[医药卫生—麻醉学]