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高腹内压腹膜假黏液瘤减瘤手术的麻醉管理：1例报告

Anesthetic management for cytoreductive surgery of pseudomyxoma peritonei with high intra-abdominal pressure: A case report.

作者信息

Lin Yan-Jun, Lu Liang-Yuan, Tao De-Qiang, Yang Zhan-Min

机构信息

Department of Anesthesiology, Aerospace Center Hospital, Beijing, China.

出版信息

Front Surg. 2023 Jan 16;9:1017500. doi: 10.3389/fsurg.2022.1017500. eCollection 2022.

DOI:10.3389/fsurg.2022.1017500
PMID:36726956
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9885852/
Abstract

Anesthetic management for patients of pseudomyxoma peritonei (PMP) is challenging. This case report describes a patient of PMP with high intra-abdominal pressure. Intubation was performed in lateral position; the intraabdominal pressure was relieved slowly to prevent significant hemodynamic changes. Additionally, positive pressure ventilation was performed to reduce the risk of re-expansion pulmonary edema. During the operation, transfusion and infusion therapy was performed with target-mediated fluid therapy according to stroke volume variation (SVV) and cardiac index (CI) and blood gas analysis.

摘要

腹膜假黏液瘤（PMP）患者的麻醉管理具有挑战性。本病例报告描述了一名腹内压高的PMP患者。在侧卧位进行插管；腹内压缓慢降低以防止显著的血流动力学变化。此外，进行正压通气以降低复张性肺水肿的风险。手术期间，根据每搏量变异度（SVV）、心脏指数（CI）和血气分析，采用目标导向液体疗法进行输血和输液治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/b9952c2cafc9/fsurg-09-1017500-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/4ff5678b75dd/fsurg-09-1017500-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/66dbac4edb0a/fsurg-09-1017500-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/64b4016aaf28/fsurg-09-1017500-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/b9952c2cafc9/fsurg-09-1017500-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/4ff5678b75dd/fsurg-09-1017500-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/66dbac4edb0a/fsurg-09-1017500-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/64b4016aaf28/fsurg-09-1017500-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c0/9885852/b9952c2cafc9/fsurg-09-1017500-g004.jpg

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本文引用的文献

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Goal-Directed Intraoperative Fluid Therapy Benefits Patients Undergoing Major Gynecologic Oncology Surgery: A Controlled Before-and-After Study.目标导向性术中液体治疗对接受大型妇科肿瘤手术的患者有益：一项前后对照研究。
Front Oncol. 2022 Apr 6;12:833273. doi: 10.3389/fonc.2022.833273. eCollection 2022.
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Prognostic impact of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients: A meta-analysis of randomized controlled trials.减瘤手术（CRS）联合腹腔热灌注化疗（HIPEC）对胃癌患者的预后影响：一项随机对照试验的荟萃分析
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Perioperative Fluid Therapy for Major Surgery.
大手术的围手术期液体治疗
Anesthesiology. 2019 May;130(5):825-832. doi: 10.1097/ALN.0000000000002603.
4
Goal-directed therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a prospective observational study.腹腔内热灌注化疗下细胞减灭术的目标导向治疗：一项前瞻性观察研究。
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