麻醉与肝移植  

Anesthesia and Liver Transplantation

作　　者：方华[1] 李利宁[1] 刘春玲[1] 陈庆廉[2] 

机构地区：[1]内蒙古自治区医院麻醉科,普外科,内蒙古呼和浩特010017 [2]浙江大学医学院第一附属医院麻醉科,浙江杭州310001

出　　处：《内蒙古医学杂志》2003年第1期42-45,共4页Inner Mongolia Medical Journal

摘　　要：目的 :探讨并论述肝移植手术期间受体的病理生理变化及麻醉管理和用药的最新进展 ;方法 :阅读关于肝移植及其麻醉方面的文献并进行总结 ;结果 :临床与实验研究表明肝移植期间受体的病理生理变化涉及到血流动力学、血电解质和酸碱平衡的改变 ,以及缺血与再灌注损伤 ,麻醉有其特殊性 ;结论 :肝移植麻醉的重点应放在对无肝前期、无肝期、新肝灌注期血流动力学的调整 ,血糖、血钾及酸碱平衡的纠正上。无肝期和新肝期要特别注意预防缺血与再灌注损伤 。Objective:To inquire and expound the newest development in the patients'pathophysiological changes and anesthetic management during liver transplantation.Method:Reading the literature about liver transplantation and anesthesia of liver transplantation,then summarizing them.Result:Clinical and experimental study show that during liver transplantation,the patients' pathophysiological changes involve in the changes of hemodynamics,elecyrolytes and acid-base balance,and liver ischemic reperfusion injury.The anesthesia has its specific characteristics.Conclusion:The anesthetic emphasis during liver transplanntation is to adjust the hemodynamics,kalemia,blood sugar and acid-base balance in the pre-anhepatic phase,the anhepatic phase and the new hepatic perfusion phase.The hepatic ischemic reperfusion injury is particularly noticed and prevented in the anhepatic perfusion phase and the new hepatic perfusion phase in order to avoid liver and kidney failure after liver transplantationn.

关 键 词：麻醉 肝移植 病理生理 血流动力学 血糖 血钾 

分 类 号：R657.3[医药卫生—外科学] R614.2[医药卫生—临床医学]