超高龄患者行复杂心脏手术的麻醉与围术期管理  

Anesthesia and perioperative management of a super-elderly patient undergoing complex cardiac surgery

作　　者：王莉萍 孙艳斌[1] 嵇富海[2] 刘学胜[3] 章放香[4] 王晓斌 刘亚涛[6] 尹春琳[7] 陈生龙[8] 薛张纲 王月兰 王天龙[11] Wang Liping;Sun Yanbin;Ji Fuhai;Liu Xuesheng;Zhang Fangxiang;Wang Xiaobin;Liu Yatao;Yin Chunlin;Chen Shenglong;Xue Zhanggang;Wang Yuelan;Wang Tianlong(Department of Anesthesiology,Central Hospital in Chengde,Chengde 067000,China;Department of Anes-thesiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Anes-thesiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Anesthesiology,Guizhou Provincial People′s Hospital,Guiyang 550002,China;Department of Anesthesiolo-gy,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Anesthe-siology,The First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Cardiology,Xu-anwu Hospital,Capital Medical University,Beijing 100053,China;Department of Cardiac Surgery,Peking University People′s Hospital,Beijing 100044,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Shandong Medical University,Jinan 250013,China;Department of Anesthesiol-ogy and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]承德市中心医院麻醉科,承德067000 [2]苏州大学附属第一医院麻醉科,苏州215006 [3]安徽医科大学第一附属医院麻醉科,合肥230022 [4]贵州省人民医院麻醉科,贵阳550002 [5]西南医科大学附属医院麻醉科,泸州646000 [6]兰州大学第一医院麻醉科,兰州730000 [7]首都医科大学宣武医院心内科,北京100053 [8]北京大学人民医院心脏外科,北京100044 [9]复旦大学附属中山医院麻醉科,上海200032 [10]山东医科大学第一附属医院麻醉与围术期医学科,济南250013 [11]首都医科大学宣武医院麻醉手术科,北京100053

出　　处：《中华麻醉学杂志》2023年第10期1252-1255,共4页Chinese Journal of Anesthesiology

摘　　要：一、病例介绍1.病历摘要(1)一般情况:患者女性,年龄87岁,身高150 cm,体质量56 kg。主因“间断胸闷、气短1月余,加重3 d”入院。患者1个月前无明显诱因出现间断性胸闷、气短,活动后加重。心脏超声提示:左心扩大,节段性室壁运动异常,左室心尖部室壁瘤形成,室间隔穿孔,心室水平左向右分流,考虑“心肌梗死后室间隔穿孔”。病情稳定后行冠状动脉造影,提示:冠状动脉左前降支中段近端95%局限性偏心性狭窄,中段远端至远段近端60%~80%弥漫性狭窄,可见重度肌桥(收缩期狭窄最重约99%)。该患者近3 d扶床行走出现胸闷气短,卧床休息无明显症状。

关 键 词：左向右分流 心脏手术 室间隔穿孔 偏心性狭窄 室壁瘤形成 心脏超声 左室心尖部 围术期管理 

分 类 号：R614[医药卫生—麻醉学]