高龄患者心脏瓣膜置换术的麻醉处理

RESEARCH ON THE ANESTHETIC MANAGEMENT FOR AGED PATIENTS WITH CARDIAC VALVE REPLACEMENT

目的探讨高龄患者行心脏瓣膜置换术的麻醉管理方法。方法回顾性分析19例高龄心脏瓣膜置换术患者的围术期资料。结果全组均顺利完成手术,术中出现高血压12例(63.2%),心动过缓10例(52.6%);术后出现室性期前收缩6例,低钾血症8例,低氧血症3例;低心排综合征3例,除死亡1例外均痊愈出院。结论高龄患者行心脏瓣膜置换手术麻醉危险性高,术前应积极改善心肺功能,术中维护心血管功能稳定,术后积极处理心律失常和低氧血症等并发症是麻醉成功的关键。

Objective To investigate the anesthetic management for aged patients with cardiac valve replacement.Methods Retrospective data from 19 aged patients with cardiac valve replacement were analyzed.Results In all 19 patients,12（63.2%） with hypertension,10（52.6%） with bradycardia intraoperatively,6 with premature ventricualr contraction,8 with hypokalemia,3 with hyoxemia and 3 with low cardiac output syndrome（LCOS） postoperatively.18 of 19 patients were cured,1 case was dead.Conclusion This result indicates that aged patients with cardiac valve replacement is high-risk.The key to successful anesthesia are actively improve cardiopulmonary function preoperatively,stability maintain cardiovascular function intraoperatively,actively management of arrhythmias and hypoxemia postoperatively,respectively.