Kanda Hirotsugu, Hirasaki Yuji, Iida Takafumi, Kanao-Kanda Megumi, Toyama Yuki, Chiba Takashi, Kunisawa Takayuki
Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan; Department of Anatomy, The Jikei University School of Medicine, Tokyo, Japan.
J Cardiothorac Vasc Anesth. 2017 Dec;31(6):2251-2267. doi: 10.1053/j.jvca.2017.04.019. Epub 2017 Apr 13.
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach. In this review, the authors summarize the available literature to address common issues related to patients with ESRD and discuss the best perioperative approach for this patient subgroup.
终末期肾病（ESRD）与心血管功能、体液、电解质及酸碱平衡的内环境稳态、骨代谢、红细胞生成以及血液凝固的显著改变相关。ESRD在全球范围内的患病率正在迅速上升，需要全身麻醉下进行手术的患者数量也在增加。由于多种合并症，ESRD患者围手术期发病和死亡风险显著更高。因此，全身麻醉下ESRD患者的围手术期管理需要特殊考虑和谨慎的多学科方法。在本综述中，作者总结了现有文献，以探讨与ESRD患者相关的常见问题，并讨论该患者亚组的最佳围手术期处理方法。
