重症风心病人二尖瓣、主动脉瓣置换加三尖瓣成形术的麻醉处理

Anesthetic Management of Patients with Rhumatoid Heart Disease Undergoing Aortic and Mitral Valve Replacement and Tricuspid Valve Plastic Repair

本文报告９１例重症风心病人施行二尖瓣、主动脉瓣置换加三尖瓣成形术的麻醉处理经验。认为采用小剂量芬太尼诱导，根据瓣膜病变类型和术前心室率选择不同肌肉松弛药，依手术刺激强弱适时调整麻醉深度，体外循环过程中注意心肌保护，复苏后合理使用血管活性药物，是此类病人麻醉处理之关键。

This paper presents the anesthetic management of 91 patients undergoing elective aortic and mitral valve replacement and tricuspid plastic repair. Based on clinical experience it is believed that the key measures ensuring patients' safety include: induction with low dose fentanyl, selection of different muscle relaxants according to the type of valve injury and ventricular rate, adjusting anesthesia depth as variation of surgical stimulation, emphysizing myocardial protection during bypass, and application of vasoactive drugs properly after cardiac resuscitation.