| 唐菲,谢言虎,章敏,等.肺移植手术患者的麻醉管理[J].中国临床保健杂志,2021,24(4):542-545. |
| 肺移植手术患者的麻醉管理 |
| Anesthetic management of lung transplantation |
| 投稿时间：2021-03-02 |
| DOI：10.3969/J.issn.1672-6790.2021.04.023 |
| 中文关键词: 肺移植 麻醉 围手术期 |
| 英文关键词: Lung transplantation Anesthesia Perioperative period |
| 基金项目:国家自然科学基金项目(81973643)；“科大新医学”联合基金创新团队项目(WK9110000055) |
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| 中文摘要: |
| 目的 回顾性总结22例肺移植手术麻醉的管理及注意事项。方法 22例终末期肺病患者行肺移植手术,连续监测肺动脉压(PAP)、中心静脉压(CVP)等指标。分别记录麻醉后5 min双肺通气时(T0)、手术开始后20 min单肺通气时(T1)、肺动脉阻断10 min时(T2)、肺动脉开放后20 min时(T3)、恢复双肺通气20 min(T4)和手术结束平卧位10 min (T5)共6个时间点的数值。结果 22例肺移植手术麻醉均顺利完成,术中麻醉基本平稳。其中,T2时的PAP明显高于其他各时点(P<0.05),而T3、T4、T5时的PAP较T0时明显降低(P<0.05)；T1、T2时的CVP明显高于其他时点(P<0.05)。结论 在肺移植手术的麻醉管理中,需要严格的术前评估、完善的麻醉监测、良好的单肺通气及呼吸管理、体外膜肺氧合技术(ECMO)的精准应用为肺移植手术麻醉提供了支持,而且维持麻醉过程中循环的稳定是重点与难点。 |
| 英文摘要: |
| Objective To analyze of the management and precautions in 22 cases of lung transplantation anesthesia respectively.Methods Twenty-two patients with end-stage lung disease,undergoing lung transplantation surgery were involved in this study.The value of PAP,CVP and other indicators were recorded in the time of two-lung ventilation for 5 min after anesthesia(T0),one-lung ventilation for 20 min after operation(T1),10 min after pulmonary artery clamping(T2),20 min after pulmonary artery unclamping(T3),recovery of two-lung ventilation for 20 min(T4) and lying position for 10 minutes after the end of operation(T5).Results The anesthesia of 22 cases of lung transplantation was completed stablely during the operation.The value of PAP at T2 was higher than that at other times (P<0.05).The value of PAP at T3,T4,T5 was lower than that at T0 (P<0.05).The value of CVP at T1 and T2 was higher than that at other times (P<0.05).Conclusion It needs strict preoperative evaluation,perfect anesthesia monitoring,good one lung ventilation technique and respiratory management,precise application of ECMO to provide the support and maintain the stability of circulation in the anesthesia process. |
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