Alvarez López J C, Solís G, Gónzalez de Zárate Apiñaniz J, Gómez Herreras J I, García Castaño J, Muñoz Fernández R
Servicio de Anestesiología y Reanimación, Hospital Universitario, Valladolid.
Rev Esp Anestesiol Reanim. 1991 Mar-Apr;38(2):115-7.
A patient with a hepatic hydatid cyst with fistula formation to inferior vena cava is reported. To carry out the resection, the cyst was isolated from systemic circulation by means of cardiopulmonary bypass. Inferior vena cava was cannulated through the right atrium until the implantation area of the cyst (above the hepatic veins) was surpassed. Bypass was carried out in 25 minutes by means of cannulation of the ascending aorta, without clamping the aorta, myocardial protection or hypothermia. Postoperative analgesia was achieved with a lumbar epidural catheter. Measures to prevent anaphylactic shock are recommended, an anesthetic technique based on the prevention of hypersensitivity reactions and a careful surgical technique to prevent hydatid dissemination.
本文报道了一例肝包虫囊肿与下腔静脉形成瘘管的患者。为了进行切除手术,通过体外循环将囊肿与体循环隔离。经右心房插入下腔静脉插管,直至超过囊肿的植入区域(肝静脉上方)。通过升主动脉插管在25分钟内完成体外循环,未夹闭主动脉、未进行心肌保护或低温处理。术后通过腰段硬膜外导管进行镇痛。建议采取措施预防过敏性休克,采用基于预防过敏反应的麻醉技术以及谨慎的手术操作以防止包虫播散。