超高龄心力衰竭患者行膀胱切开取石术麻醉管理1例  

Anesthesia management in an elderly patient with heart failure undergoing cystotomy and lithotomy:a case report

作　　者：欧阳杰[1] 思永玉[1] Ouyang Jie;Si Yongyu(Department of Anesthesiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院麻醉手术科,昆明650101

出　　处：《国际麻醉学与复苏杂志》2023年第3期305-310,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：随着高龄患者日益增多,手术患者合并基础疾病的情况屡见不鲜,各类复杂病例对临床麻醉工作带来了十分艰巨的挑战。该病例为90岁超高龄患者且合并较复杂的心肺疾病最终导致心力衰竭,需行膀胱切开取石手术。经术前充分的评估与准备,多学科协作调整术前诊疗方案,优化患者器官功能,正确选择外科手术方式、术中合理的麻醉方案,应用血流动力学监测手段密切关注患者生命体征变化并优化液体管理策略,尽量降低患者围手术期风险以安全度过围手术期,最终患者无严重并发症被治愈出院。Elderly patients complicated with underlying diseases are very common,and it is daunting to clinical work due to all kinds of complex cases.The patient was 90 years old,and complicated cardiopulmonary disease eventually led to heart failure,re⁃quiring cystolithotomy cystolithectomy.Adequate preoperative evaluation,multi⁃disciplinary cooperation to realize organ function opti⁃mization and change of surgical methods were carried out,reasonable intraoperative anesthesia plan,the use of advanced monitoring methods to pay close attention to the patient's vital signs,optimized fluid management to minimize the perioperative risk of the patient safely,and finally cured and discharged without severe complications.

关 键 词：高龄老人 心力衰竭 冠状动脉粥样硬化性心脏病 术前评估 麻醉 

分 类 号：R614[医药卫生—麻醉学]