同种异体原位肝移植术的麻醉围手术期处理

Perioperative anesthesia management of allograft orthotopic liver transplantation

探讨临床同种异体原位肝移植围手术期的麻醉处理。方法：在动物实验的基础上实施临床同种 异体原位肝移植麻醉。选择合适的麻醉前用药、麻醉方法及麻醉药物，术中注意输液、扩容、维持循环血量、行体外 静脉－静脉转流术。适量应用血管活性药物、支持循环、维持血流动力学稳定。结果：麻醉效果满意。血压在门静 脉及下腔静脉转流后回升。供肝置入复流时血压为 １４．３－ １５．６／７．８～９．１ｋＰａ（１１０－ １２０／６０－７０ ｍｍＨｇ）。结论：选 择合适的麻醉前用药、麻醉方法及麻醉药物及行体外静脉－静脉转流术，有助于维持血液动力学的稳定。术后呼吸 支持和镇痛是必要的。

Aim:To investigate the anesthetic methods for clinical allograft orthotopic liver transplantation.Methods:Employ anesthesia for clinical allograft orthotopic livertransplantation based on animal experiments.Select rational preanesthetics, anethetic method and anesthatics.Pay attention to infusion,enhancing vesselcapacity,keeping circulation volume,establishing veno-ve-nous bypass.Vasoactive drugs in appropriate dosage could support circulation and maintain the stability of hemodynamic,Results: The effect of anesthesia is satisfactary.The blood pressure was increased while portal vein and inferior vena cava are clamping,and it was 14.3~15.6/7.8~9.1kPa(110~120/60~70mmHg)after the graft implanted .Conclusion:It is benefit to maintain the stability of hemodynamic by using rational preanesthetics,anesthetic method,anesthetics and establishment of veno-venous bypass. It is necessary to support respiration and kill pain after the operation