经皮二尖瓣缘对缘修复术的围手术期管理  

Perioperative management of percutaneous edge‑to‑edge mitral valve repair

作　　者：张海霞[1] 徐佳[1] 乔昌龙 王月兰 吕蒙 Zhang Haixia;Xu Jia;Qiao Changlong;Wang Yuelan;Lyu Meng(Department of Anesthesiology,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hos-pital),Shandong Institute of Anesthesia and Respiratory Critical Medicine,Jinan 250014,China;Department of Anesthesiology,Shan-dong Provincial Hospital Affiliated to Shandong First Medical University(Shandong Provincial Hospital),Jinan 250021,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)麻醉科,山东省麻醉与呼吸危重症研究所,济南250014 [2]山东第一医科大学附属省立医院(山东省立医院)麻醉科,济南250021

出　　处：《国际麻醉学与复苏杂志》2024年第1期72-76,共5页International Journal of Anesthesiology and Resuscitation

基　　金：山东省医学会临床科研资金齐鲁专项(YXH2022ZX02088)。

摘　　要：经皮二尖瓣缘对缘修复术(PMVR)是治疗手术风险高或不适合传统手术的严重二尖瓣反流(MR)患者的一种安全、可行的替代方法。文章对PMVR的围手术期管理进行了详细、全面的概述,包括充分的术前评估、采用何种麻醉方式、术中的监测指标、麻醉的诱导及维持策略、血管活性药物的选择、围手术期液体管理、呼吸参数的调整、严重并发症的预防和早期诊断等方面,以期为术者术中操作提供良好的操作环境并保障患者安全、减少围手术期并发症发生率提供理论参考。Percutaneous edge‑to‑edge mitral valve repair(PMVR)is a safe and effective alternative therapy for severe mitral regurgitation(MR)in patients who are at a high risk of traditional surgery or are not suitable for traditional surgery.This article provides a comprehensive overview of perioperative management of PMVR,including adequate preoperative assessment,how to select anesthesia methods,intraoperative monitoring indicators,anesthesia strategies for induction and maintenance,selection of vasoactive agents,perioperative fluid management,adjustment of respiratory parameters,and early diagnosis and prevention of serious complications.These findings will provide theoretical evidence for establishing a good operating environment for the surgeons,safeguarding the safety of patients,and reducing the incidence of perioperative complications.

关 键 词：二尖瓣 心瓣膜修复术 二尖瓣反流 围手术期 麻醉管理 

分 类 号：R654.2[医药卫生—外科学]