腰硬联合麻醉对肾移植手术患者围术期血流动力学的影响

Influence of Spinal-epidural Combined Anesthesia on Perioperative Hemodynamics of Renal Transplantation Patients

【目的】探讨腰硬联合麻醉下肾移植手术受体围术期血流动力学变化规律。【方法】随机选择100例肾移植术患者，在腰硬联合麻醉下行同种异体肾移植手术，观察其血流动力学的变化。【结果】腰硬联合麻醉后10 min收缩压（SBP）、平均动脉压（MAP）、舒张压（DBP）明显下降（ P ＜0．05），阻断髂静脉20 min后SBP、MAP、DBP逐渐恢复到麻醉前水平，移植肾血流开放后SBP、DBP、MAP明显下降。【结论】腰硬联合麻醉用于肾移植手术效果理想、确切；其对血流动力学影响在不同手术阶段有不同的变化，控制平稳的关键在于各阶段的麻醉处理是否得当。

[Objective] To explore the perioperative hemodynamic change rule of the recipients undergoing renal transplantation under spinal-epidural combined anesthesia .[Methods]Totally 100 patients undergoing re-nal transplantation were randomly selected .Allograft renal transplantation was performed under spinal-epi-dural combined anesthesia .The changes of hemodynamics were observed .[Results]Systolic blood pressure （SBP） ,mean arterial pressure（MAP） and diastolic blood pressure（DBP） 10min after spinal-epidural combined anesthesia were obviously decreased（ P 〈0 .05） .SBP ,MAP and DBP 20 min after blocking iliac vein were gradually restored to the level before anesthesia .SBP ,DBP and MAP after the opening of blood flow of trans-planted kidney were obviously decreased .[Conclusion]Spinal-epidural combined anesthesia in renal transplan-tation has ideal and exact efficacy .The influence of spinal-epidural combined anesthesia on hemodynamic chan-ges is different at different operation stages .Proper anesthesia management in each stage is the key to keep stable hemodynamic .