合并术前谵妄的超高龄患者腹腔镜横结肠部分切除术的麻醉与围术期管理  

Anesthesia and perioperative management of a super-elderly patient with preoperative delirium undergoing laparoscopic partial transverse colectomy

作　　者：孙渊 王天龙[1] 肖玮[1] 薛张纲 王东信[3] 尹春琳[4] 王古岩 陈世彪[6] 李茜[7] 张国娟[8] 王朝东[9] 安大力 Sun Yuan;Wang Tianlong;Xiao Wei;Xue Zhanggang;Wang Dongxin;Yin Chunlin;Wang Guyan;Chen Shibiao;Li Qian;Zhang Guojuan;Wang Chaodong;An Dali(Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Anesthesiology,Peking University First Hospital,Beijing 100034,China;Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100069,China;Department of Anesthesiology,The First Affiliated Hospital of Nanchang University,Nanchang 330000,China;Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Nephrology,Beijing Tongren Hospital,Capital Medical University,Beijing 100069,China;Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of General Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学宣武医院麻醉手术科,北京100053 [2]复旦大学附属中山医院麻醉科,上海200032 [3]北京大学第一医院麻醉科,北京100034 [4]首都医科大学宣武医院心内科,北京100053 [5]首都医科大学附属北京同仁医院麻醉科,北京100069 [6]南昌大学第一附属医院麻醉科,南昌330000 [7]四川大学华西医院麻醉科,成都610041 [8]首都医科大学附属北京同仁医院肾内科,北京100069 [9]首都医科大学宣武医院神经内科,北京100053 [10]首都医科大学附属北京同仁医院普外科,北京100069

出　　处：《中华麻醉学杂志》2024年第6期742-745,共4页Chinese Journal of Anesthesiology

摘　　要：(1)一般情况:患者男性,年龄93岁,身高170 cm,体质量53 kg,BMI 18.3 kg/m^(2)。因"直肠癌术后4年余,间断腹痛2个月"入院。患者4年前行腹部CT检查发现直肠-乙状结肠交界处占位,结肠癌可能,伴结肠梗阻。行电子结肠镜检查示:进镜10 cm可见环周不规则隆起阻塞肠腔,内镜无法通过,直肠10 cm活检,病理结果示中分化管状腺癌浸润,伴坏死。患者于2018年5月行全麻下腹腔镜直肠癌根治术(Dixon),术后恢复可。2个月前间断出现腹痛,影像学检查提示横结肠脱垂,门诊以"直肠癌术后、结肠脱垂"收入院。患者自发病以来,精神差,睡眠不佳,尿频尿少,体质量无明显变化。

关 键 词：管状腺癌 超高龄患者 围术期管理 结肠梗阻 电子结肠镜检查 病理结果 直肠癌术后 谵妄 

分 类 号：R614[医药卫生—麻醉学]