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巨大小脑梗死合并严重主动脉瓣狭窄患者开颅手术的麻醉管理:一例报告

Anesthetic management for craniotomy in a patient with massive cerebellar infarction and severe aortic stenosis: a case report.

作者信息

Xu Ai-Jun, He Zhi-Gang, Xia Xiao-Hua, Xiang Hong-Bing

机构信息

Department of Anesthesiology and Pain Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, Hubei, PR China.

出版信息

Int J Clin Exp Med. 2015 Jul 15;8(7):11534-8. eCollection 2015.

Abstract

Severe aortic stenosis combined with coronary heart disease remarkably increases the risk of perioperative morbidity and mortality during noncardiac surgery. Surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. Therefore, understanding of the hemodynamic changes and anesthetic implications is an important for successful perioperative outcome. This report described the anesthetic management of a patient with a massive cerebellar infarction who was diagnosed with severe aortic stenosis combined with moderate aortic insufficiency and coronary heart disease and hypertension. He was prepared for aortic valve replacement and coronary bypass operation before massive cerebellar infarction occurred. And he received decompressive craniotomy and external ventricular drainage in the prone position under general anesthesia with endotracheal intubation.

摘要

严重主动脉瓣狭窄合并冠心病会显著增加非心脏手术围手术期发病和死亡风险。若未进行充分监测和妥善护理,手术及麻醉常使围手术期结局复杂化。因此,了解血流动力学变化及麻醉影响对围手术期取得成功结局至关重要。本报告描述了一名大面积小脑梗死患者的麻醉管理情况,该患者被诊断为严重主动脉瓣狭窄合并中度主动脉瓣关闭不全、冠心病及高血压。在大面积小脑梗死发生前,他已准备接受主动脉瓣置换术和冠状动脉搭桥手术。他在全身麻醉气管插管下俯卧位接受了减压开颅术及脑室外引流。

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