静脉转流下背驮式原位肝移植术的麻醉处理(附1例报告)

ANESTHESIA MANAGEMENT FOR PIGGYBACK ORTHOTOPIC LIVER TRANSPLANTATION (1 CASE REPORT)

报告１例患原发性胆汁性肝硬化病人行背驮式肝移植术的麻醉处理。麻醉方法采用静吸复合全麻加连续硬膜外阻滞。在无肝期采用人工心肺机在全身肝素化下进行门静脉－腋静脉转流。结果：无肝期出血少，血流动力学稳定；肝脏恢复血流时出现再灌注综合征，经处理，５ｍｉｎ后血流动力学恢复稳定；手术结束时凝血功能基本恢复正常。术后２４ｈ病人恢复良好。

This is a report on the anesthesia management of a patient with primary biliary cirrhorsis undergoing piggyback orthotopic liver transplantation A combination of intravenous and inhalation anesthesia coupled with continuous epidural anesthesia was employed During the anhepatic phase a porto axillary venovenous bypass with systemic heparinization was establisthed by a conventional cardiac bypass apparatus Result:Bleeding was minimum and the hemodynamics was stable during the anhepatic phase;Reperfusion syndrome occured after the renewal of hepatic blood circulation.The hemodynamics became stable within five minutes after treatment;Coagulation became normal when the operation was completed The patient had a good recovery during the first 24 h after the operation