主动脉夹层瘤覆膜支架介入治疗的麻醉管理及注意事项

Anesthetic management and related issues in interventional treatment with covered stent for aortic dissection aneurysm

目的探讨主动脉夹层瘤覆膜支架介入治疗的麻醉管理及注意事项。方法选择我院自2016年3月至2017年3月收治的40例主动脉夹层瘤患者,对其实施覆膜支架介入治疗,手术前做好患者降压、防感染准备工作,手术过程中行静吸复合麻醉以及采用硝普钠降低血压,在患者体内植入覆膜支架治疗,手术后采取措施预防术后并发症及镇痛。观察比较干预前后患者心率、收缩压、舒张压变化。结果 40例患者覆膜支架植入手术均顺利完成,干预后血流动力学变化明显,差异有统计学意义(P<0.05)。结论针对主动脉夹层瘤覆膜支架介入治疗患者,实施静吸复合麻醉以及相应控制血压措施,能够有效提高治疗安全性,实施方便,镇痛效果明显,且易控制,值得临床推广。

Objective To investigate anesthetic management and related issues in interventional treatment with covered stent for aortic dissection aneurysm. Methods A total of 40 patients with aortic dissection aneurysm who were admitted to our hospital from March 2016 to March 2017 were enrolled and given interventional treatment with covered stent. The measures to reduce blood pressure and prevent infection were adopted before surgery, and then a covered stent was placed; related measures were taken after surgery to prevent postoperative complications and control pain. The changes in heart rate, systolic pressure, and diastolic pressure after intervention were observed. Results The covered stent was successfully placed in all 40 patients, and there was a significant change in hemodynamics after intervention （P〈0.05）. Conclusion In patients with aortic dissection aneurysm undergoing interventional treatment with covered stent, intravenous-inhalation anesthesia and measures for blood pressure control are convenient and easy to control and can effectively improve the safety of treatment and control the pain. Therefore, they hold promise for clinical application.