高龄共病患者行经内镜逆行胆胰管成像的麻醉管理1例报告  

Anesthetic management of an elderly patient with comorbidities undergoing endoscopic retrograde cholangiopancreatography:A case report

作　　者：孙华 郭永馨 郭英[1] 张修礼[3] 苑洪涛[4] 周飞虎[5] 段伟东[6] 王晓琳[1] SUN Hua;GUO Yongxin;GUO Ying;ZHANG Xiuli;YUAN Hongtao;ZHOU Feihu;DUAN Weidong;WANG Xiaolin(Department of Anaesthesia,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Xinxing Bridge Outpatient,Jingnan Medical District of Chinese PLA General Hospital,Beijing 100841,China;Department of Gastroenterology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Cardiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Critical Medicine,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Hepatobiliary,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心麻醉科,北京100853 [2]解放军总医院京南医疗区新兴桥门诊部,北京100841 [3]解放军总医院第一医学中心消化内科,北京100853 [4]解放军总医院第一医学中心心血管内科,北京100853 [5]解放军总医院第一医学中心重症医学科,北京100853 [6]解放军总医院第一医学中心肝胆外科,北京100853

出　　处：《解放军医学院学报》2023年第7期827-829,共3页Academic Journal of Chinese PLA Medical School

摘　　要：本文报告1例急性胆管炎老年女性患者,患者出现高热、黄疸,且合并胰腺占位、肺部感染、胸腔积液、泌尿系感染、冠心病、帕金森,诊治难度大,术后风险高。经过多学科讨论,专家决定规避外科手术风险,在内镜下行经内镜逆行胆胰管成像微创治疗,并为患者制定了合理的诊疗方案和个性化的麻醉方案。术后患者顺利出院。多学科协作为麻醉医师提供了重要脏器功能评估和手术麻醉选择的建议,可有效襄助麻醉管理,降低围术期风险,更好地维持患者术后功能状态。This article reports an elderly female patient with acute cholangitis who had high fever,jaundice,and the comorbidities of space-occupying lesions in the pancreas,pulmonary infection,pleural effusion,urinary tract infection,coronary heart disease,and Parkinson’s disease,which led to the difficulties in diagnosis and treatment and high risks after surgery.After multidisciplinary discussions,the experts decided to conduct minimally invasive endoscopic retrograde cholangiopancreatography to avoid the risk of surgery and formulated rational diagnostic and therapeutic protocol and personalized anesthetic regimen for the patient.The patient was successfully discharged after surgery.Multidisciplinary cooperation provides anesthesiologists with suggestions for evaluating organ function and selecting surgical anesthesia and can effectively help anesthesia management,reduce perioperative risks,and better maintain the functional status of patients after surgery.

关 键 词：急性胆管炎 胆道感染 围术期管理 多学科协作 

分 类 号：R473.6[医药卫生—护理学]