妊娠中期合并急性A型主动脉夹层患者麻醉管理1例

A Case Report of Anesthesia Management of Second Trimester of PregnancyComplicated with Stanford Type A Aortic Dissection

妊娠期并发急性A型主动脉夹层罕见且凶险,严重危及孕妇及胎儿的生命。一旦确诊应紧急行外科手术治疗,在治疗夹层的同时尽可能保证胎儿成活。围术期麻醉管理的难度在于麻醉药物的选择和术中患者生命体征的维持,尤其是在体外循环期间患者血流动力学及体温的调控,对降低麻醉药物对胎儿的影响、提高孕妇及胎儿的存活率至关重要。本文回顾性分析我院收治的1例妊娠中期合并急性A型主动脉夹层患者的手术麻醉过程,并结合文献回顾,以期为该类患者的救治提供参考。

Acute type A aortic dissection during pregnancy is rare and dangerous,which seriously endangers the life of pregnant women and fetuses.Once diagnosed,surgery should be performed urgently to treat the dissection while keeping the fetus alive as much as possible.The difficulty of perioperative anesthesia management lies in the selection of anesthetic drugs and the maintenance of patients'vital signs,especially the regulation of hemodynamics and body temperature during cardiopulmonary bypass,which plays an important role in reducing side effects of anesthetic drugs on the fetus and improving the survival rate of pregnant women and fetuses.In this paper,we retrospectively analyzed the anesthesia process of a patient with acute type A aortic dissection in the second trimester of pregnancy,in order to provide reference for the treatment of such patients.