脑血运重建术的围手术期麻醉管理

Perioperative anesthesia management of cerebral revascularization

脑血运重建术可用来增加或替代有脑缺血危险患者的脑血流量,如烟雾病、脑血管闭塞性疾病、颅底肿瘤和复杂动脉瘤等。文章分别从麻醉管理、术后管理、并发症的预防三方面来分析总结脑血运重建术的围手术期管理策略。术中管理重点在于维持稳定的脑血流量和正常的颅内压,从而优化脑氧供需平衡,术后管理则应严格进行血流动力学监测及疼痛控制,减少术后并发症的发生。然而,脑血运重建术的围手术期管理策略仍需要深入研究和不断探索,从而改善患者的远期生活质量,为临床提供更多的参考。

Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of cerebral ischemia,such as moyamoya disease,occlusive cerebrovascular disease,skull base tumors,and complex aneurysms.The paper analyzes and summarizes the perioperative management strategies of cerebral revascularization from three aspects:anesthesia management,postoperative management,and prevention of complications.Intraoperative management focuses on maintaining stable cerebral blood flow and normal intracranial pressure,to optimize the balance between cerebral oxygen supply and demand.Postoperative management should strictly carry out hemodynamic monitoring and pain control to reduce postoperative complications.However,the perioperative management strategy of cerebral revascularization still needs further research and continuous exploration to improve the long-term quality of life of patients and provide more references for clinical practice.