摘要
目的总结8例同种异体原位心脏移植手术和2例心肺联合移植手术的麻醉处理经验。方法术前依据患者心肺功能及全身状况,给予强心、利尿、营养心肌等治疗。采用静吸复合麻醉,气管插管控制呼吸,在心肺转流下行同种异体原位心脏移植手术或心肺联合移植手术。根据血流动力学监测选用合适剂量的多巴胺、肾上腺素、异丙肾上腺素等血管活性药物。结果10例患者术中血流动力学均平稳,术后17~25h拔除气管导管,无早期死亡。结论术前重视对心肺功能的调整,术中维护血流动力学的稳定,术后正确处理右心功能不全和低心排是心脏移植手术和心肺联合移植手术的麻醉关键。
Objective To summarize the anesthetic managements in the patients undergoing orthotopic heart transplantation or orthotopic heart-lung transplantation. Methods According to preoperative cardiac function and general status of the patients, improvement of cardiac function, diuresis and myocardial nutrition management were taken. Under combined intravenous with inhalational anesthesia, orthotopic heart transplantation was performed in 8 patients and orthotopic heart-lung transplantation in 2 patients. The operation was performed with the aid of extraeorporeal circulation. Vasoactive drugs were used based on hemodynamic data. Results The hemodynamics of 10 patients were stable. The endotracheal tubes were taken away in 17-25 hours after operation. There were no early deaths. Conclusion Particular attention should be paid to improving cardiac function before operation, maintaining hemodynamics stable during procedure, and managing properly right heart insufficiency and low cardiac output postoperatively in the patients undergoing orthotopic heart transplantation or orthotopic heart-lung transplantation.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第6期487-489,共3页
Journal of Clinical Anesthesiology
关键词
心脏移植
心肺联合移植
血流动力学
Heart transplantation
Heart-lung transplantation
Hemodynamics