犬辅助肝移植手术的麻醉处理体会

Experience of Anesthesia Management on Auxiliary Liver Transplantation in Dogs

目的探讨犬辅助性肝移植模型术中麻醉处理的特点。方法选成年杂交健康普通犬26只,在气管插管全麻下进行辅助性肝移植模型,经颈外静脉和颈总动脉置管监测平均动脉压和心率,移植中分别在腹主动脉部分阻断前、阻断后15 min,开放后15 min采取动脉血进行血气分析。结果共完成犬辅助性肝移植13次,术中无麻醉死亡,阻断及开放腹主动脉后血流动力学波动明显并伴有代酸,再灌注期血钾升高明显。结论术中应注意维持血流动力学平稳,积极预防纠正再灌注后酸碱平衡失调及电解质紊乱。

Objective To study the characteristic issues of anesthesia management on auxiliary liver transplantation. Methods 26 healthy dogs were operated to establish an auxiliary liver transplantation model under general anesthesia and trachea intubation. Mean arterial pressure and heart rate were monitored by external jugular vein and common carotid artery cannulation. Arterial blood samples were taken, before and 15 minutes after aorta blocking and 15 minutes after aorta opening, for blood gas analysis. Results No anesthetic death occurred among all the 13 cases during operation period. The apparent hemodynamic fluctuation of recipient dogs was observed during the period of abdominal aorta blocking and opening. Metabolic acidosis also took place during this period. Apparent rise of blood potassium was detected during reperfusion period. Conclusion In order to improve the survival rate, it is important to actively maintain the stability of hemodynamics, acid-base balance and correct electrolyte disturbance.