重度肺动脉高压病人行全髋关节置换麻醉管理1例并文献复习  

ANESTHETIC MANAGEMENT OF TOTAL HIP ARTHROPLASTY IN A PATIENT WITH SEVERE PULMONARY HYPERTENSION:A CASE REPORT AND LITERATURE REVIEW

作　　者：李琳[1] 刘英志[1] 马晓军[1] 刘少艳[1] LI Lin;LIU Yingzhi;MA Xiaojun;LIU Shaoyan(Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2023年第3期446-448,共3页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市公共领域科技支撑计划项目(11-2-3-1-(16)-nsh)。

摘　　要：目的探寻重度肺动脉高压病人行全髋关节置换安全有效的麻醉管理方法。方法回顾性分析1例重度肺动脉高压病人行全髋关节置换的麻醉管理,并复习国内外相关文献。结果本例病人术前诊断为重度肺动脉高压,入手术室后给予髂筋膜联合骶丛神经阻滞,围手术期静脉泵注曲前列尼尔注射液(商品名瑞莫杜林),术中病人生命体征平稳,术后回访病人无胸闷、憋气等不适,复查超声心动图未见加重。结论肺动脉高压病人行全髋关节置换术,神经阻滞联合静脉麻醉可提供完善镇静镇痛,联合应用前列环素类药物(如瑞莫杜林)有助于病人安全度过围手术期。Objective To investigate the safe and effective anesthetic management of total hip arthroplasty in patients with severe pulmonary hypertension.Methods A retrospective analysis was performed for the anesthetic management of total hip arthroplasty in one patient with severe pulmonary hypertension,and a literature review was performed for related articles in China and globally.Results The patient was diagnosed with severe pulmonary hypertension before surgery and was given nerve block of the fascia iliaca and sciatic plexus after entering the operating room before surgery and intravenous pumping of treprostinil injection(with a trade name of Remodulin)in the perioperative period.The vital signs were stable during surgery,postoperative follow-up showed no chest distress or suffocation,and reexamination of echocardiography showed no aggravation.Conclusion In total hip arthroplasty for patients with pulmonary hypertension,nerve block combined with intravenous anesthesia can provide perfect sedation and analgesia,and the combined application of prostacyclin drugs(such as Remodulin)can ensure perioperative safety.

关 键 词：肺动脉高压 关节成形术 置换 髋 麻醉 

分 类 号：R614[医药卫生—麻醉学] R541.5[医药卫生—外科学]